Abstract
BackgroundPredicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with ‘no paramedic treatment’ for cases referred for emergency ambulance dispatch following secondary telephone triage.MethodsA retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012. Multivariable logistic regression modelling was used to identify explanatory variables associated with ‘no paramedic treatment’.ResultsThere were 19,041 cases eligible for inclusion in this study over almost three years, of which 8510 (44.7%) were not treated after being sent an emergency ambulance following secondary triage. Age, time of day, pain, triage guideline group, and comorbidities were associated with ‘no paramedic treatment’. In particular, cases 0–4 years of age or those with psychiatric conditions were significantly less likely to be treated by paramedics, and increasing pain resulted in higher rates of paramedic treatment.ConclusionsThis study highlights that case characteristics can be used to identify particular case types that may benefit from care pathways other than emergency ambulance dispatch. This process is also useful to identify gaps in the alternative care pathways currently available. These findings offer the opportunity to optimise secondary telephone triage services to support their strategic purpose of minimising unnecessary emergency ambulance demand and to match the right case with the right care pathway.
Highlights
Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways
Identifying cases unlikely to be treated by paramedics that appear suitable for diversion to alternative forms of transportation or care can potentially reduce the demand for emergency ambulances and better align appropriate care pathways with patient need
Study design A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012
Summary
Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. In order to manage increasing demand some ambulance services have implemented secondary telephone triage services, whereby specific low-acuity cases undergo a nurse, doctor or paramedic-led telephone triage prior to or concurrent with an emergency ambulance dispatch [13, 15,16,17,18,19,20,21,22]. The goal of this triage is to reduce the demand for emergency ambulances by diverting suitable cases to alternative transportation or management pathways [15, 23]. Using emergency ambulance resources for cases not requiring specific paramedic treatment when other options exist is an inappropriate and costly use of resources and does not provide the most suitable care for these patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
