Declining Use of Pre-Hospital Emergency Medical Services During the COVID-19 Pandemic in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany

Abstract

Background: The COVID-19 pandemic affects utilisation of health care services and posed organizational challenges. To determine the effect on utilisation of pre-hospital emergency medical care, we investigate utilisation throughout the year of 2020. Methods: This retrospective, descriptive analysis of routine data from 26 dispatch centres in Bavaria, Germany investigates the number of emergencies per 100,000 population as well as relative change in emergency rates and transport rates in 2020, compared to the two previous years. Boxplots show distributions across Bavarian districts per calendar week. Mean rates and standard deviations as well as relative changes are presented for specific periods and a paired samples t-test is used to compares rates. Findings: Compared to the average of the two previous years, emergency rates in 2020 were lower in 35 out of 52 calendar weeks. Strongest reductions were observed during the first wave, where the average emergency rate declined by 12∙9% (SD 6∙8, p Interpretation: Utilisation of pre-hospital emergency medical services decreased in 2020, especially during periods with strict measures. This could be due to lower morbidity from behavioural changes during the pandemic, but also to avoidance of medical services for probably both, less urgent and severe conditions. While a reduction in unnecessary care would be beneficial, patients must be encouraged to seek necessary urgent care, even during a pandemic. Funding: None to declare.Declaration of Interest: None to declare. Ethical Approval: The study was approved by the ethics committee of the medical faculty of the University of Munich (Project-No 21-0641 KB).