Mahmuda Sabnam, Wade-Vallance Adam, Stosic Alix, Guenter Dale, Howard Michelle, Agarwal Gina, McLeod Brent, Angeles Ricardo
McMaster University, Hamilton, Ontario, Canada.
McMaster Institute for Research on Aging, Hamilton, Ontario, Canada.
Health Promot Pract. 2020 May;21(3):440-447. doi: 10.1177/1524839918799504. Epub 2018 Sep 15.
Frequent users of emergency medical services (EMS) have disproportionately high 9-1-1 call frequency. Evidence suggests that this small group burdens the health care system, leading to misallocation of already-limited health resources.
To understand frequent users' perceptions and experiences regarding EMS, as well as the driving factors underlying their frequent use.
A grounded theory approach guided our qualitative research process. Participants older than 17 years who called EMS five or more times in the past year were consecutively sampled where each participant was contacted in the order they appeared on our list of potential participants for interviews until data saturation was achieved. Transcripts were analyzed to derive common themes among frequent EMS callers.
Frequent EMS calls often resulted from chronic medical conditions creating recurrent crisis situations, mental health issues as well as mobility issues, frequent noninjurious falls, and social isolation. Combined with these factors, perceptions of the purpose of EMS and social circumstances also contributed to the creation of complex health issues that influenced frequent EMS use. These findings can advise the development of future paramedicine programs and health promotion interventions.
急诊医疗服务（EMS）的频繁使用者拨打911的频率极高。有证据表明，这一小群体给医疗保健系统带来了负担，导致本就有限的卫生资源被错误分配。
了解频繁使用者对EMS的看法和体验，以及他们频繁使用的驱动因素。
扎根理论方法指导了我们的定性研究过程。对过去一年拨打EMS五次或以上的17岁以上参与者进行连续抽样，按照他们在潜在参与者名单上出现的顺序联系每位参与者进行访谈，直至达到数据饱和。对访谈记录进行分析，以得出频繁拨打EMS者之间的共同主题。
频繁拨打EMS通常是由慢性疾病引发反复危机情况、心理健康问题以及行动不便问题、频繁的非伤害性跌倒和社会孤立所致。结合这些因素，对EMS目的的认知和社会环境也导致了复杂健康问题的产生，进而影响了对EMS的频繁使用。这些发现可为未来护理计划和健康促进干预措施的制定提供参考。
