Disparities between two possible thresholds for frequent contacts to a Norwegian emergency medical communication centre: ≥5 contacts in one month vs. ≥12 contacts in three months.

backgroundFrequent callers are described as a challenge for Emergency Medical Services (EMS) across international contexts, but the terminology, definitions, and frequency vary. Until 2023, the UK’s Frequent Caller National Network (FreCaNN) definition was ≥ 5 incidents in one month or ≥ 12 incidents in three months. In this study we applied that definition to compare the two possible thresholds independently on data from Norway’s largest Emergency Medical Communication Centre (EMCC).

methodsA retrospective cross-sectional database review of all patients who met the former FreCaNN definition of frequent contacts to the medical emergency number 1-1-3 at Oslo EMCC between 1. January 2017 and 31. December 2022, also including all ages, and instances where others called on behalf of a patient.

resultsA total of 19.559 unique identities met the inclusion criteria. Of them, 16.518 patients accumulated 130.814 contacts to the EMCC relating to individual episodes 5 or more times in one month, but fewer than 12 in three months. For the group with 12 or more contacts in three months, 3.041. patients accumulated 137.909 contacts. Almost all those with ≥ 12 contacts within three-months also met the ≥ 5 contacts in one month criterion. Those who had ≥ 12 contacts in three months tended to be significantly younger (median age: 58 vs. 70) and more likely to make the call themselves (64% vs. 32%). Regarding chief complaints, they had a higher frequency of “unidentified problems” (34% vs. 22%), “mental health problems” (20% vs. 8.2%), and “intoxication/OD” (7.2% vs. 4.4%) and were less likely to be prioritized as urgent (54% vs. 82%). An ambulance was less often dispatched (38% vs. 69%), and they were less often taken to either a doctor (17% vs. 25%) or to a hospital (13% vs. 32%) (all p < .001).

conclusionThese results show disparities and indicate that there are two distinct subgroups within the former FreCaNN definition. In the Norwegian context focusing on the ‘12 contacts in three months’ component allows for improved specificity and a more manageable number of individuals, for further research to identify effective targeted clinical measures to improve patient care. CLINICAL TRIAL NUMBER: Not applicable.