Victor C R, Peacock J L, Chazot C, Walsh S, Holmes D
Department of Public Health Sciences, St George's Hospital Medical School, London.
J Accid Emerg Med. 1999 May;16(3):174-8. doi: 10.1136/emj.16.3.174.
In 1996-97 there were 623,000 emergency (999) calls made to the London Ambulance Service (LAS) and this represents a 30% increase over the previous five years. The reasons for this increase, which is also observed nationally, remain unknown. It has been suggested that some callers may be using the 999 service "inappropriately" but no data are available from the ambulance service.
To describe the workload of the emergency ambulance service in London with specific reference to the nature and characteristics of 999 calls, to determine who dials 999 and why, and to establish the number and types of calls that could most appropriately be dealt with by other agencies.
A one week census of all emergency calls responded to by the LAS.
Sixty eight LAS stations.
Collation of all routine LAS incident forms (LA4) including the classification of the crews' free text description of the incident. This was supplemented by a detailed workload questionnaire for 25% of calls.
There were 10,921 calls responded to from 29 April to 5 May 1996. The census showed that the daily number of calls was highest on Saturday and lowest on Wednesday with about half being made during normal general practitioner (GP) working hours. Half of all calls were for women and one third were for people aged > or = 65. Accidents were the commonest type of incident (24%). The remainder comprised various medical conditions such as respiratory, cardiac, and obstetric problems. In 1.5% of calls there was no illness, injury, or assistance required and 5% were for "general assistance" and mostly concerned people aged > or = 65. The workload survey indicated that two thirds of incidents occurred at home and 70% of callers had not tried to contact a GP before dialing 999. In the professional opinion of the responding crew, 60% of calls required a 999 response, with the remainder thought more appropriately dealt with by other services such as primary care, psychiatric services, and social services.
This study suggests that while the majority of 999 calls were "appropriate", part of the 999 workload could be dealt with by other services. More research is required to clarify why people contact the 999 service for non-emergency incidents and also to establish the views of GPs and other agencies as to the role and function of the IAS.
1996 - 1997年，伦敦救护车服务中心（LAS）共接到62.3万个急救（999）电话，较前五年增长了30%。全国范围内也出现了这种增长，但其原因尚不清楚。有人认为一些来电者可能在“不恰当地”使用999服务，但救护车服务部门没有相关数据。
描述伦敦急救救护车服务的工作量，特别提及999电话的性质和特点，确定拨打999的人员及其原因，并确定其他机构最适合处理的电话数量和类型。
对LAS响应的所有急救电话进行为期一周的普查。
68个LAS站点。
整理所有常规的LAS事件表格（LA4），包括对工作人员对事件的自由文本描述的分类。对25%的电话补充了详细的工作量问卷。
1996年4月29日至5月5日共接到10921个电话。普查显示，周六的每日电话数量最高，周三最低，约一半的电话是在普通全科医生（GP）正常工作时间拨打的。所有电话中一半是女性拨打的，三分之一是65岁及以上人群拨打的。事故是最常见的事件类型（24%）。其余包括各种医疗状况，如呼吸、心脏和产科问题。1.5%的电话不需要医疗、受伤或援助，5%是“一般援助”电话，大多涉及65岁及以上人群。工作量调查表明，三分之二的事件发生在家中，70%的来电者在拨打999之前没有尝试联系全科医生。根据响应工作人员的专业意见，60%的电话需要999响应，其余的认为更适合由其他服务部门处理，如初级保健、精神科服务和社会服务。
这项研究表明，虽然大多数999电话是“恰当的”，但999工作量的一部分可以由其他服务部门处理。需要更多研究来阐明人们为何因非紧急事件联系999服务，以及确定全科医生和其他机构对LAS的作用和功能的看法。
