Hegenberg Kathrin, Althammer Alexander, Gehring Christian, Prueckner Stephan, Trentzsch Heiko
Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, Ludwigs-Maximilians-Universität München, Schillerstr. 53, 80336 Munich, Germany.
Healthcare (Basel). 2023 Jul 8;11(14):1983. doi: 10.3390/healthcare11141983.
The COVID-19 pandemic affected the utilization of health care services and posed organizational challenges. While many previous studies focused on the misuse of pre-hospital EMS for low-urgency health problems, the pandemic has put more emphasis on the avoidance of medically necessary calls.
To compare the utilization of pre-hospital emergency medical services before and after specific pandemic periods.
DESIGN, SETTING AND PARTICIPANTS: This was a retrospective, descriptive analysis of routine data from 26 dispatch centers in Bavaria, Germany.
We investigated the number of emergencies per 100,000 population, as well as the relative change in the emergency rates and transport rates in 2020, compared to the two previous years. Boxplots showed the distributions across the Bavarian districts per calendar week. The mean rates and standard deviations as well as the relative changes were presented for the specific periods. A paired samples -test was used to compare the rates.
Compared to the average of the two previous years, the emergency rates in 2020 were lower in 35 out of 52 calendar weeks. The strongest reductions were observed during the first wave, where the average emergency rate declined by 12.9% (SD 6.8, < 0.001). There was no statistically significant difference in the overall emergency rate during the summer holidays. Lower transport rates were observed throughout the year, especially during the first wave.
Utilization of pre-hospital emergency medical services decreased in 2020, especially during the periods with strict measures. This could be due to the lower morbidity from the behavioral changes during the pandemic, but also to the avoidance of medical services for both less urgent and severe conditions. While a reduction in unnecessary care would be beneficial, patients must be encouraged to seek necessary urgent care, even during a pandemic.
新冠疫情影响了医疗服务的利用，并带来了组织方面的挑战。虽然此前许多研究关注的是院前急救医疗服务被滥用于低紧急程度的健康问题，但疫情使人们更加重视避免拨打必要的医疗求助电话。
比较特定疫情时期前后院前急救医疗服务的利用情况。
设计、地点与参与者：这是一项对德国巴伐利亚州26个调度中心的常规数据进行的回顾性描述性分析。
我们调查了每10万人口中的紧急情况数量，以及2020年与前两年相比紧急情况发生率和转运率的相对变化。箱线图展示了每个日历周巴伐利亚州各地区的分布情况。呈现了特定时期的平均发生率、标准差以及相对变化。使用配对样本t检验来比较发生率。
与前两年的平均水平相比，2020年52个日历周中有35周的紧急情况发生率较低。在第一波疫情期间观察到降幅最大，平均紧急情况发生率下降了12.9%（标准差6.8，P<0.001）。暑假期间总体紧急情况发生率没有统计学上的显著差异。全年的转运率都较低，尤其是在第一波疫情期间。
2020年院前急救医疗服务的利用有所减少，尤其是在采取严格措施的时期。这可能是由于疫情期间行为变化导致发病率降低，但也可能是因为对不太紧急和严重的病情都避免寻求医疗服务。虽然减少不必要的医疗护理有益，但必须鼓励患者即使在疫情期间也寻求必要的紧急护理。
