ArticleBMC emergency medicine2026
Comparing emergency medical service and walk-in patients in German emergency departments: a prospective multicentre survey.
Article in BMC emergency medicine, 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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15 authors.
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Abstract
backgroundEmergency department (ED) crowding is a major concern across Europe. This study compares EMS-transported and walk-in patients across EDs in different settlement types with regard to care-seeking behaviour, presenting complaints and awareness of alternative care pathways.
methodsWe conducted a prospective, multicentre survey among patients in 20 EDs in Berlin and Bavaria (Mar–Oct 2024). A tablet-based questionnaire captured sociodemographics, presenting complaints, perceived urgency and health-care utilisation. EMS and self-referred patients (walk-ins) were compared using χ² and Mann–Whitney U-tests. Multivariable logistic models examined predictors of EMS use and attendance at predominantly urban versus intermediate EDs.
resultsOf 9,719 patients, 2,641 (27.2%) arrived by EMS. EMS patients were older and more likely to attend predominantly urban EDs. They had more often cardio-respiratory or neurological complaints, whereas pain predominated in walk-ins. Prior outpatient contact was less common among EMS patients (29.3%). In adjusted regional analyses, injury-related presentations were more common in predominantly urban EDs (20.5% vs. 26.3%; p = 0.003), while cardio-respiratory and abdominal complaints showed no differences. Awareness of national on-call service number (116117) was associated with higher odds of predominantly urban attendance.
conclusionsEMS patients differ from walk-ins in age, presentation and care-seeking. Differences between regions in case-mix and pre-hospital decision-making suggest that strategies to improve emergency care coordination may benefit from region-sensitive approaches. Whether integration of structured telephone advice (116117) and digital self-assessment tools with EMS dispatch can contribute to more appropriate resource allocation warrants prospective evaluation. REGISTRATION: DRKS00033986; DRKS00034961.
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