Bensoussan Melisande, Vannier Mathilde, Loeb Thomas, Boutet Jérémie, Lapostolle Frédéric, Reuter Paul-Georges
Samu des Hauts-de-Seine, Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, 92380, France.
SAMU 93 - UF Recherche-Enseignement-Qualité, Université Paris 13, Assistance Publique-Hôpitaux de Paris, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, 125, rue de Stalingrad, Bobigny, 93009, France.
Scand J Trauma Resusc Emerg Med. 2025 Jan 13;33(1):6. doi: 10.1186/s13049-024-01315-w.
Emergency Medical Communication Centres (EMCCs) play a crucial role in emergency care by ensuring timely responses through telephone triage. However, extended communication times can impede accessibility, patient triage, and decision-making. Identifying the factors influencing communication duration is essential for improving EMCC efficiency.
This study aims to identify temporal, human, and contextual factors associated with prolonged communication times in an EMCC where decision-making is conducted by physicians.
We conducted a retrospective observational study of all calls received at a French EMCC between March 1 and December 31, 2019. A total of 108,548 patient medical files were analyzed, excluding calls from medical personnel or hospitals. We examined the total communication time (from call initiation to decision) and the medical communication time (physician involvement). Bivariate and multivariate logistic regressions were used to identify factors associated with prolonged communication times.
The median total communication time was 7 min [IQR 5-11], and the median medical communication time was 3 min [IQR 2-4]. Psychiatric reasons for calling (OR = 1.75) and elderly patients (OR = 1.58) were associated with longer communication times. Calls leading to medical advice (OR = 1.48) and calls during weekends or nighttime were also significant factors. Conversely, calls for trauma or from nursing homes, and those handled by emergency physicians, were associated with shorter durations.
Several factors influence communication times in EMCCs, including patient demographics, reason for the call, and time of day.
紧急医疗通信中心（EMCCs）在紧急护理中发挥着关键作用，通过电话分诊确保及时响应。然而，延长的通信时间可能会妨碍可及性、患者分诊和决策制定。识别影响通信时长的因素对于提高EMCC效率至关重要。
本研究旨在识别与由医生进行决策的EMCC中通信时间延长相关的时间、人员和情境因素。
我们对2019年3月1日至12月31日期间法国一个EMCC接到的所有呼叫进行了回顾性观察研究。共分析了108548份患者医疗档案，排除了来自医务人员或医院的呼叫。我们检查了总通信时间（从呼叫发起至决策）和医疗通信时间（医生参与时间）。采用二元和多元逻辑回归来识别与通信时间延长相关的因素。
总通信时间中位数为7分钟[四分位间距5 - 11]，医疗通信时间中位数为3分钟[四分位间距2 - 4]。因精神疾病呼叫（比值比=1.75）和老年患者（比值比=1.58）与更长的通信时间相关。导致医疗建议的呼叫（比值比=1.48）以及周末或夜间的呼叫也是重要因素。相反，创伤呼叫或来自养老院的呼叫以及由急诊医生处理的呼叫与较短时长相关。
EMCC中的通信时间受多种因素影响，包括患者人口统计学特征、呼叫原因和一天中的时间。
