Buhtz Christian, Fleischer Steffen, Heinrich Stephanie, Bork Annett, Meyer Gabriele, Mikolajczyk Rafael, Lückmann SaraLena
Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany.
Profilzentrum Gesundheitswissenschaften, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany.
Gesundheitswesen. 2023 Oct;85(10):904-910. doi: 10.1055/a-1961-1145. Epub 2022 Dec 19.
Utilization of emergency care is subject to demographic changes. In Germany, there was an increase of 4% to 6% annually between the years 2000 and 2017. Studies revealed that age and regional structures were related to utilization. The aim of this cross-sectional study was to analyze utilization of pre-hospital emergency medical services in Saxony-Anhalt and to identify associated factors.
Based on data from the AOK Saxony-Anhalt for 2019, transportation with ground ambulances of insured persons living in Saxony-Anhalt were identified and recorded. Insured time of all AOK insured persons living in Saxony-Anhalt was used to determine incidence rates. For the multivariate analysis of associated factors, a Poisson regression model was adapted.
112,575 transportations of patients were identified; an average of 1.53 events per person or 149.6 per 1,000 person years. Inpatient hospital treatment was provided for 53.2% of emergency patients and outpatient hospital treatment for 37.1%. Frequent users represented 14.6% of the events. The incidence rate was highest for older persons and those with care dependency. In addition, the risk of using emergency services was higher among men and in suburban and urban regions (compared with rural regions), even after adjustment.
Utilization is higher in the cohort studied compared to that found in other studies. The high proportion where inpatient hospital treatment is not necessary, as well as the clear association with care dependency and age, offer possible angles of approach for interventions to relieve the burden on emergency services.
急诊护理的使用情况会受到人口结构变化的影响。在德国，2000年至2017年间，其年增长率为4%至6%。研究表明，年龄和地区结构与使用情况有关。这项横断面研究的目的是分析萨克森-安哈尔特州院前紧急医疗服务的使用情况，并确定相关因素。
基于2019年萨克森-安哈尔特州AOK的数据，确定并记录了居住在萨克森-安哈尔特州的参保人员乘坐地面救护车的情况。使用居住在萨克森-安哈尔特州的所有AOK参保人员的参保时间来确定发病率。对于相关因素的多变量分析，采用了泊松回归模型。
共确定了112,575例患者运输情况；平均每人1.53次事件，或每1000人年149.6次。53.2%的急诊患者接受了住院治疗，37.1%接受了门诊治疗。频繁使用者占事件的14.6%。老年人和有护理依赖的人发病率最高。此外，即使经过调整，男性以及郊区和城市地区（与农村地区相比）使用紧急服务的风险更高。
与其他研究相比，本研究队列中的使用率更高。不必要住院治疗的比例较高，以及与护理依赖和年龄的明显关联，为减轻紧急服务负担的干预措施提供了可能的切入点。
