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争分夺秒:丹麦西兰大区基于登记的 2013-2022 年紧急救护车派遣和反应时间研究。

Racing against time: Emergency ambulance dispatches and response times, a register-based study in Region Zealand, Denmark, 2013-2022.

机构信息

Prehospital Center, Region Zealand, Ringstedgade 61, 13th floor, 4700, Næstved, Denmark.

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

出版信息

Scand J Trauma Resusc Emerg Med. 2024 Nov 6;32(1):108. doi: 10.1186/s13049-024-01284-0.

Abstract

BACKGROUND

The global strain on Emergency Medical Services (EMS) is reflected in the increasing number of emergency ambulance dispatches. Shorter EMS response times have demonstrated some effect on very specific and rare conditions. It is unknown if the increased number of ambulance dispatches compromises response times. This study aimed to describe trends in emergency ambulance dispatches and response times from 2013 to 2022 in Region Zealand, Denmark. Additionally, it aimed to outline the demographic profile of emergency ambulance patients, including age and comorbidities.

METHODS

Using administrative data from the Region Zealand emergency medical dispatch center, a register-based study spanning from January 1, 2013, to December 31, 2022, was conducted. Data were linked with nationwide registries and priority A (emergency), or B (urgent) ambulance dispatches were included. Trends were examined overall and stratified by catchment areas corresponding to the hospitals with emergency departments in the region. Poisson and ordinal logistic regressions were used to analyze data.

RESULTS

The study encompassed 678,789 emergency ambulance dispatches, with 55.0% priority A and 45.0% priority B. Among these, 667,788 had a valid personal identification number allowing for further analysis. Within the study population, females comprised 48.5%, while 49.1% of patients were 65 years or more. Overall, 47.5% of patients had no comorbidities, while 7.7% and 44.8% had mild and severe comorbidities, respectively. Emergency ambulance dispatches increased from 56,867 in 2013 to 81,080 in 2022 (143%). Correspondingly, the dispatch incidence rate per 1,000 residents per year increased from 69.2 to 95.5. Stratification by catchment areas revealed significant disparities. The median response time for priority A dispatches increased from 7 min:14 s in 2013 to 8 min:20 s in 2022 and for priority B dispatches from 12 min:23 s to 15 min:6 s.

CONCLUSIONS

From 2013 to 2022, emergency ambulance dispatches both priorities A and B increased in absolute numbers and per 1000 residents per year. Ambulance response times also increased for both priorities during the study period. The study shows regional disparities regarding to the rate of emergency ambulance dispatches and response times indicating challenges in resource distribution in the future for maintaining emergency care standards.

摘要

背景

全球对紧急医疗服务(EMS)的需求不断增加,体现在紧急救护车派遣数量的增加上。EMS 响应时间的缩短已经证明对某些特定和罕见的情况有一定效果。但是,增加的救护车派遣数量是否会影响响应时间还不得而知。本研究旨在描述 2013 年至 2022 年期间丹麦 Zealand 地区的紧急救护车派遣情况和响应时间趋势,并概述紧急救护车患者的人口统计学特征,包括年龄和合并症。

方法

使用 Zealand 地区紧急医疗调度中心的行政数据,进行了一项基于登记的研究,时间跨度为 2013 年 1 月 1 日至 2022 年 12 月 31 日。数据与全国性登记处相关联,并纳入了优先级为 A(紧急)或 B(紧急)的救护车派遣。整体和按对应于该地区急诊医院的服务区进行分层,对趋势进行了检查。使用泊松和有序逻辑回归分析数据。

结果

该研究共涉及 678789 次紧急救护车派遣,其中 55.0%为优先级 A,45.0%为优先级 B。其中,667788 次有有效的个人识别号码,可进一步进行分析。在研究人群中,女性占 48.5%,而 65 岁及以上的患者占 49.1%。总体而言,47.5%的患者没有合并症,而 7.7%和 44.8%的患者分别有轻度和重度合并症。紧急救护车派遣数量从 2013 年的 56867 次增加到 2022 年的 81080 次(增加了 143%)。相应地,每 1000 名居民的派遣发生率从 69.2 增加到 95.5。按服务区分层显示出显著差异。优先级 A 派遣的中位数响应时间从 2013 年的 7 分 14 秒增加到 2022 年的 8 分 20 秒,优先级 B 的响应时间从 12 分 23 秒增加到 15 分 6 秒。

结论

从 2013 年到 2022 年,优先级 A 和 B 的紧急救护车派遣数量无论是绝对值还是每 1000 名居民每年的数量都有所增加。在研究期间,优先级 A 和 B 的救护车响应时间也都有所增加。该研究表明,在紧急救护车派遣数量和响应时间方面存在地区差异,这表明未来在资源分配方面存在挑战,以维持紧急护理标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6a2/11542390/88896b5a8dbe/13049_2024_1284_Fig1_HTML.jpg

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