Chi C H, Lee H L, Wang S M, Tsai L M
Department of Emergency Medicine, National Cheng Kung University Medical College, 138 Sheng-Li Road, Tainan, Taiwan.
J Formos Med Assoc. 2001 Jan;100(1):14-9.
Although many studies have examined the reasons for repeated use of emergency medical service (EMS), little information is available concerning repeated ambulance use in Taiwan. This study evaluated the characteristics of repeated EMS ambulance use in an urban EMS system in Taiwan.
Data from a local EMS computerized database for the period from January 1996 through December 1998 were collected for analysis. All calls to the dispatch center that resulted in EMS transports were included. Repeat users were identified by matching the user name, sex, age, and home address. Transports were categorized according to how many times the patient was transported by ambulance during the 3-year period: single use, one time; repeated use, two or three times; or frequent use, more than three times.
During the 36-month study period, there were 41,792 calls, with 13,076 non-transports (a non-transport rate of 31.3%). Of the 28,716 transports during the study period, 2,101 represented repeated or frequent use (7.3%); the rate of frequent use was 1.4% (406/28,716). The frequency of repeated use reached a daily first peak at 8:00 AM, with the second and third peaks at 1:00 PM and 7:00 PM. The mean age increased with increasing repeated use of transport (37.25 +/- 0.24 vs 41.55 +/- 1.03 vs 46.23 +/- 1.57 years, respectively; p < 0.001). The percentage of non-trauma missions increased with increasing repeated use of transport (26.3% vs 55.6% vs 73.2%; p < 0.001). Response time significantly increased for repeated use (analysis of variance [ANOVA], p < 0.001). The on-scene interval (time from arrival until departure) in the single-use group was shorter than in the repeated and frequent use groups (ANOVA, p < 0.005).
The results of this study indicate that the characteristics of repeat users of EMS transport differ from those of single users. Characteristics of service time, reason for transport, and interval to each subsequent call varied among different groups of users. Studies of repeat use under a wider range of conditions such as in rural EMS systems and after implementation of a priority-dispatch system are needed to determine the implications of repeated ambulance use.
尽管许多研究探讨了重复使用紧急医疗服务（EMS）的原因，但关于台湾地区重复使用救护车的信息却很少。本研究评估了台湾一个城市EMS系统中重复使用EMS救护车的特点。
收集了当地EMS计算机数据库中1996年1月至1998年12月期间的数据进行分析。所有导致EMS转运的调度中心呼叫均被纳入。通过匹配用户名、性别、年龄和家庭住址来识别重复使用者。根据患者在3年期间被救护车转运的次数对转运进行分类：单次使用，1次；重复使用，2次或3次；或频繁使用，超过3次。
在36个月的研究期间，共有41,792次呼叫，其中13,076次未进行转运（未转运率为31.3%）。在研究期间的28,716次转运中，2,101次代表重复或频繁使用（7.3%）；频繁使用的比例为1.4%（406/28,716）。重复使用的频率在上午8:00达到每日第一个高峰，下午1:00和晚上7:00出现第二和第三个高峰。随着转运重复使用次数的增加，平均年龄上升（分别为37.25±0.24岁、41.55±1.03岁和46.23±1.57岁；p<0.001）。非创伤性任务的百分比随着转运重复使用次数的增加而增加（26.3%、55.6%、73.2%；p<0.001）。重复使用时响应时间显著增加（方差分析[ANOVA]，p<0.001）。单次使用组的现场停留时间（从到达至离开的时间）短于重复使用组和频繁使用组（ANOVA，p<0.005）。
本研究结果表明，EMS转运的重复使用者特征与单次使用者不同。不同用户组的服务时间、转运原因以及每次后续呼叫的间隔时间特征各不相同。需要在更广泛的条件下进行重复使用的研究，如在农村EMS系统中以及实施优先调度系统之后，以确定重复使用救护车的影响。
