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. 2016 Oct 26;6(10):e013849.
doi: 10.1136/bmjopen-2016-013849.

Factors associated with the difficulty in hospital acceptance at the scene by emergency medical service personnel: a population-based study in Osaka City, Japan

Yusuke Katayama  1 , Tetsuhisa Kitamura  2 , Kosuke Kiyohara  3 , Taku Iwami  4 , Takashi Kawamura  4 , Sumito Hayashida  5 , Kazuhisa Yoshiya  1 , Hiroshi Ogura  1 , Takeshi Shimazu  1
Affiliations

Factors associated with the difficulty in hospital acceptance at the scene by emergency medical service personnel: a population-based study in Osaka City, Japan

Yusuke Katayama et al. BMJ Open. .

Abstract

Objectives: To investigate the association between the difficulty in hospital acceptance at the scene by emergency medical service (EMS) personnel and prehospital demographic factors and reasons for EMS calls.

Design: A retrospective, observational study.

Setting: Osaka City, Japan.

Participants: A total of 100 649 patients transported to medical institutions by EMS from January 2013 to December 2013.

Primary outcome measurements: The definition of difficulty in hospital acceptance at the scene was EMS personnel making ≥5 phone calls to medical institutions until a decision to transport was determined. Multivariable analysis was used to assess the relationship between difficulty in hospital acceptance and prehospital factors and reasons for EMS calls.

Results: Multivariable analysis showed the elderly, foreigners, loss of consciousness, holiday/weekend, and night-time to be positively associated with difficulty in hospital acceptance at the scene. As reasons for EMS calls, gas poisoning (adjusted OR 3.281, 95% CI 1.201 to 8.965), trauma by assault (adjusted OR 2.662, 95% CI 2.390 to 2.966), self-induced drug abuse/gas poisoning (adjusted OR 4.527, 95% CI 3.921 to 5.228) and self-induced trauma (adjusted OR 1.708, 95% CI 1.369 to 2.130) were positively associated with the difficulty in hospital acceptance at the scene.

Conclusions: Ambulance records in Osaka City showed that certain prehospital factors such as night-time were positively associated with difficulty in hospital acceptance at the scene, and reasons for EMS calls, such as self-induced drug abuse/gas poisoning, were also positive predictors for difficulty in hospital acceptance at the scene.

Keywords: emergency medical service; hospital acceptance; pre-hospital factors.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Patient flow in this study. EMS, emergency medical service.
Figure 2
Figure 2
Histogram of the number of phone calls made to hospitals by emergency medical service (EMS) personnel at the scene.
Figure 3
Figure 3
The correlation between time interval from first call to hospital until hospital acceptance. EMS, emergency medical service.
See this image and copyright information in PMC

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