Office of Medical Affairs, The New York City Fire Department, Brooklyn, New York 11201, USA.
Prehosp Emerg Care. 2011 Jul-Sep;15(3):371-80. doi: 10.3109/10903127.2011.561403. Epub 2011 Apr 26.
Emergency medical services (EMS) systems are used by the public for a range of medically related problems.
To understand and analyze the patterns of EMS utilization and trends over time in a large urban EMS system so that we may better direct efforts toward improving those services.
The 63 call type designations from all New York City (NYC) 9-1-1 EMS calls between 1999 and 2007 were obtained and grouped into 10 broad and 30 specific medical categories. Aggregated numbers of total EMS calls and individual categories were divided by NYC resident population estimates to determine utilization rates. Temporal trends were evaluated for statistical significance with Spearman's rho (ρ).
There were 9,916,904 EMS calls between 1999 and 2007, with an average of 1,101,878 calls/year. Utilization rates increased from 129.5 to 141.9 calls/1,000 residents/year over the study period (average annual rise of 1.16%). Among all medical/surgical call types (excluding trauma), there was an average annual increase of 1.8%/year. The most substantial increases were among "psychiatric/drug related" (+5.6%/year), "generalized illness" (+3.2%/year), and "environmental related" calls (+2.9%/year). The largest decrease was among "respiratory" calls (-1.2%/year), specifically for "asthma" (-5.0%/year). For trauma call types, there was an annual average decrease of 0.4%/year, with the category of "violence related" calls having the greatest decline (-3.3%/year).
There was an increase in overall EMS utilization rates, though not all call types rose uniformly. Rather, a number of significant trends were identified reflecting either changing medical needs or changing patterns of EMS utilization in NYC's population.
公众会因各种与医疗相关的问题而使用紧急医疗服务（EMS）系统。
了解和分析大型城市 EMS 系统中 EMS 使用的模式和随时间的变化趋势，以便我们能够更好地努力改进这些服务。
获取了 1999 年至 2007 年期间纽约市（NYC）所有 9-1-1 EMS 呼叫的 63 种呼叫类型，并将其分为 10 个广泛类别和 30 个具体医疗类别。将 EMS 总呼叫次数和个别类别次数除以 NYC 居民人口估算数，以确定使用率。使用 Spearman's rho（ρ）评估时间趋势的统计学意义。
1999 年至 2007 年间共发生 9916904 次 EMS 呼叫，平均每年有 1101878 次呼叫。在研究期间，使用率从 129.5 次/每千人/年增加到 141.9 次/每千人/年（平均每年增加 1.16%）。在所有医疗/手术呼叫类型（不包括创伤）中，平均每年增加 1.8%。增长最大的是“精神疾病/药物相关”（+5.6%/年）、“一般性疾病”（+3.2%/年）和“环境相关”（+2.9%/年）。“呼吸”（-1.2%/年），特别是“哮喘”（-5.0%/年）呼叫数量下降最多。对于创伤呼叫类型，平均每年下降 0.4%，其中“暴力相关”呼叫类别下降幅度最大（-3.3%/年）。
总体上 EMS 使用率有所增加，尽管并非所有呼叫类型都均匀增加。相反，确定了一些重要趋势，这些趋势反映了纽约市人口中医疗需求的变化或 EMS 使用模式的变化。
