[Arrival times of emergency services in out-of-hospital cardiac arrest-Survival-relevant differences between federal states in Germany].

BACKGROUND

The response time ("Hilfsfrist") in Germany is an important planning parameter that determines the arrival times of emergency medical services and is regulated by state legislation. This study analyzes arrival times in the German federal states.

MATERIAL AND METHOD

The German Resuscitation Registry uniformly records arrival times for the first vehicle on the scene and the complete team (team arrival time: ambulance and emergency physician) nationwide. The statistical testing of the null hypothesis, equality between the federal states, was conducted using the Kruskal-Wallis test. Binary logistic regression analyses were used to examine the impact of arrival times on survival rates.

RESULTS

The null hypothesis had to be rejected (p < 0.001), indicating that arrival times differ between the federal states (first vehicle: mean arrival times ranged from 5.7 ± 2.6 min to 7.4 ± 3.5 min; 90th percentile: 9-13 min; team arrival time ranged from 8.6 ± 3.6 min to 11.9 ± 5.9 min; 90th percentile: 13-21 min; 2014-2024: n = 104,657; 201 ambulance services). In 10 out of 16 federal states, fewer than 80% of patients were reached by the first vehicle within 8 min. The regression analyses showed that longer arrival and team arrival times were negatively associated with good neurological recovery at discharge (team arrival time ≥ 12 min: odds ratio, OR =0.54, confidence interval, CI =0.39-0.75, p < 0.001; n = 45,873; 71 reference emergency medical services, EMS, sites).

CONCLUSION

Patients receive qualitatively different levels of care across the federal states due to variations in arrival times. Shorter arrival times are associated with better chances of survival. Equal quality of care is a constitutional requirement by the German constitution but it is not being achieved.