ArticleCureus2026
Impact of the COVID-19 Pandemic on Patients' Refusal of Emergency Medical Services (EMS) Transport.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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0 citing papers in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Emergency Medical Services (EMS) activations declined during the coronavirus disease 2019 (COVID-19) pandemic. The reasons patients accept or decline EMS evaluation and transport are multifactorial. This study examined changes in EMS transport refusal rates during the early COVID-19 pandemic compared with the prior year. Methodology Run reports were obtained from a single ground ambulance service (SouthStar EMS, North Augusta, South Carolina, USA). Calls during the first 90 days following the U.S. national emergency declaration for COVID-19 (March 13-June 11, 2020) were compared with the same period in 2019. A total of 1,889 calls occurred in 2019, and 1,707 calls occurred in 2020. Runs were categorized as emergent (911) or non-emergent scheduled transports. Outcomes were analyzed using Fisher's exact test. Results Emergent calls increased from 1,148/1,889 (60.8%) in 2019 to 1,301/1,707 (76.2%) in 2020 (p < 0.00001). Refusal of EMS-recommended transport after evaluation increased from 66/1,148 (5.7%) in 2019 to 113/1,301 (8.7%) in 2020 (p = 0.0021). The combined proportion of patients refusing evaluation or refusing recommended transport increased from 189/1,148 (16.5%) to 249/1,301 (19.1%) (p = 0.0376). Conclusions During the early COVID-19 pandemic, refusal of EMS-recommended transport increased significantly in this EMS system. These findings suggest that pandemic-related concerns may have influenced patient decision-making regarding prehospital care. Further multi-system studies are needed to better characterize contributing factors and clinical outcomes.
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