Abstract
BackgroundSince the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home in Sweden.MethodsA descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns.ResultsOf all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00–11:59 interval (p < 0.001, χ2 = 1224.08).ConclusionThe issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice.
Highlights
Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt
The overall study aim was to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home
Older adults were more likely to be conveyed to hospital compared to the adult population
Summary
Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt . Approximately 1.5 million people in Sweden are aged > 70 years [7], a population that is estimated to rise by 25% over the 15 years [8]. The population of the current 0.5 million people aged > 80 years [7] is estimated to rise by 61% in the same period [8]. A global ranking places Sweden 11th [9] with an average life expectancy of 84.7 years for women and 81.3 years for men [10]. The emergency needs of the older adult population living at home will substantially impact future ambulance care
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