Fischer Matthias, Harding Ulf, Genzwürker Harald, Seewald Stephan, Gretenkort Peter, Reifferscheid Florian
Arbeitsgemeinschaft Südwestdeutscher Notärztinnen und Notärzte e. V. (AGSWN), Filderstadt, Deutschland.
DRK Göppingen, Göppingen, Deutschland.
Anaesthesiologie. 2025 Sep 16. doi: 10.1007/s00101-025-01592-9.
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.
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.
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).
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.
德国的响应时间（“救助期限”）是一个重要的规划参数，它决定了紧急医疗服务的到达时间，并受州立法的规范。本研究分析了德国联邦各州的到达时间。
德国复苏登记处统一记录全国范围内第一辆车到达现场的时间以及完整团队（团队到达时间：救护车和急诊医生）的到达时间。使用Kruskal-Wallis检验对联邦各州之间无差异这一原假设进行统计检验。二元逻辑回归分析用于检验到达时间对生存率的影响。
原假设必须被拒绝（p < 0.001），这表明联邦各州之间的到达时间存在差异（第一辆车：平均到达时间从5.7±2.6分钟到7.4±3.5分钟；第90百分位数：9 - 13分钟；团队到达时间从8.6±3.6分钟到11.9±5.9分钟；第90百分位数：13 - 21分钟；2014 - 2024年：n = 104,657；201个救护服务）。在16个联邦州中的10个州，不到80%的患者在8分钟内被第一辆车送达。回归分析表明，更长的到达时间和团队到达时间与出院时良好的神经功能恢复呈负相关（团队到达时间≥12分钟：优势比，OR = 0.54，置信区间，CI = 0.39 - 0.75，p < 0.001；n = 45,873；71个参考紧急医疗服务站点）。
由于到达时间的差异，联邦各州的患者接受的护理质量存在质的不同。更短的到达时间与更好的生存机会相关。平等的护理质量是德国宪法规定的要求，但并未实现。
