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. 2023 Jul 8;11(14):1983.
doi: 10.3390/healthcare11141983.

Pre-Hospital Emergency Medical Services Utilization Amid COVID-19 in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany

Kathrin Hegenberg  1 , Alexander Althammer  1 , Christian Gehring  1 , Stephan Prueckner  1 , Heiko Trentzsch  1
Affiliations

Pre-Hospital Emergency Medical Services Utilization Amid COVID-19 in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany

Kathrin Hegenberg et al. Healthcare (Basel). .

Abstract

Background and importance: The COVID-19 pandemic affected the utilization of health care services and posed organizational challenges. While many previous studies focused on the misuse of pre-hospital EMS for low-urgency health problems, the pandemic has put more emphasis on the avoidance of medically necessary calls.

Objective: To compare the utilization of pre-hospital emergency medical services before and after specific pandemic periods.

Design, setting and participants: This was a retrospective, descriptive analysis of routine data from 26 dispatch centers in Bavaria, Germany.

Outcomes measure and analysis: We investigated the number of emergencies per 100,000 population, as well as the relative change in the emergency rates and transport rates in 2020, compared to the two previous years. Boxplots showed the distributions across the Bavarian districts per calendar week. The mean rates and standard deviations as well as the relative changes were presented for the specific periods. A paired samples t-test was used to compare the rates.

Main results: Compared to the average of the two previous years, the emergency rates in 2020 were lower in 35 out of 52 calendar weeks. The strongest reductions were observed during the first wave, where the average emergency rate declined by 12.9% (SD 6.8, p < 0.001). There was no statistically significant difference in the overall emergency rate during the summer holidays. Lower transport rates were observed throughout the year, especially during the first wave.

Conclusions: Utilization of pre-hospital emergency medical services decreased in 2020, especially during the periods with strict measures. This could be due to the lower morbidity from the behavioral changes during the pandemic, but also to the avoidance of medical services for 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.

Keywords: COVID-19; ambulance; emergency medical services; pre-hospital; utilization.

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Conflict of interest statement

The authors have no relevant financial or non-financial interest to disclose.

Figures

Figure 1
Figure 1
(a) Timeline of COVID-19 response measures; (b) Distribution of 7-day incidence across the 96 Bavarian districts during calendar weeks 1-52; (c) Percentage change in mobility in Bavaria during calendar weeks 1-52, compared to 2019, horizontal line represents no change; (d) Distribution of percentage change in emergency rates across the 96 Bavarian districts in 2020 compared to the average of both previous years during calendar weeks 1-52, horizontal line represents no change; (e) Distribution of proportion of transported patients across the 96 Bavarian districts, horizontal line represents median transport rate of the two previous years.
Figure 2
Figure 2
Boxplot of distribution of the percentage change in transport rates across the 96 Bavarian districts, by time period.
See this image and copyright information in PMC

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