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. 2025 Feb 1;33(1):17.
doi: 10.1186/s13049-025-01332-3.

An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands

Susanne E de Loor  1 , Tessa Verheij  1 , Thomas Karol  1 , Franciscus G M H M Cuppen  1 , Frits van Dijk  1 , Femke Goldstein  1 , Joyce Janssen  1 , Remco H A Ebben  2
Affiliations

An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands

Susanne E de Loor et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Non-conveyance is an increasing part of ambulance care and has to be safe. One of the indicators to measure safety is an ambulance re-contact within 72 h. However, solely measuring the percentage of re-contacts has limited validity as it lacks insight in actual reasons of an ambulance re-contact. Therefore, the aim of our study was to analyze the incidence, reasons and outcomes of ambulance re-contacts within 72 h after non-conveyance.

Methods: We conducted a one year (2022) retrospective study in one EMS region in the Netherlands. Medical records of all non-conveyance runs with a re-contact were analyzed using a framework to categorize re-contact reasons in illness-related, patient-related, professional-related, and unrelated. Re-contact outcomes were measured in terms of (non-)conveyance and mortality.

Results: 585/13.879 (4.2%) non-conveyance runs had a re-contact within 72 h. 547/585 (93.5%) re-contacts could be categorized with the framework. Re-contacts were related to the illness (n = 267, 48.8%), the patient (n = 130, 23.8%), the professional (n = 106, 19.4%) and unrelated (n = 44, 8.0%). Four subreasons accounted for 68.5% of reasons for re-contacts: progression of disease (19.4%), recurrent disease process/exacerbation (18.6%), reassessment and ambulance request by another medical professional (15.9%), and psychiatric disorder and/or substance abuse (14.6%). 403/547 (73.7%) patients with a re-contact were conveyed to the hospital. Mortality rate for patients with a re-contact was 0.5%.

Conclusions: Re-contact incidence after non-conveyance is relatively low, with a very small part of re-contacts related to ambulance care professionals making errors in diagnosis or treatment. Combined with low re-contact mortality, this indicates safe non-conveyance decisions. Re-contacts as quality indicator cover a variety of reasons, with almost half of the re-contacts being related to illness. Four subcategories accounted for the majority of all reasons for re-contacts: progression of disease, recurrent disease process/exacerbation, reassessment and ambulance request by another medical professional, and psychiatric disorder and/or substance abuse. Three-quarters of the patients were conveyed, although more re-contacts due to patient related reasons ended in non-conveyance again.

Keywords: Emergency medical services [MeSH]; Non-conveyance; Patient safety [MeSH].

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was reviewed by the Research Ethics Committee of the Radboud University Medical Centre. The declared the study not subject to the Human Subjects Act and Medical Treatment Contracts Act (reference 2023–16621). Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

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