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Non-conveyance in the ambulance service: A population-based cohort study in Stockholm, Sweden
Sophiahemmet University.ORCID iD: 0000-0002-1163-0054
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2020 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 7, article id e036659Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Non-conveyed patients represent a significant proportion of all patients cared for by ambulance services in the western world. However, scientific knowledge on non-conveyance is sparse. Therefore, the aim of this study was to describe the prevalence of non-conveyance, investigate associations and compare patients' characteristics, drug administration, initial problems and vital signs between non-conveyed and conveyed patients.

DESIGN: A population-based retrospective cohort study.

SETTING: The study setting area, Stockholm, Sweden, has a population of 2.3 million inhabitants, with seven emergency hospitals. Annually, approximately 210 000 assignments are performed by 73 ambulances. All ambulance assignments performed from 1 January to 31 December 2015 were included.

RESULTS: In total, 23 603 ambulance assignments ended in non-conveyance-13.8% of all ambulance assignments performed in 2015. Compared with conveyed patients, non-conveyed patients were younger and more often female (median age 50.1 years for non-conveyed vs 61.7 years for conveyed; female=52 %, both p values <0.001). Approximately half of all ambulance assignments ending in non-conveyance were initially prioritised and dispatched as the highest priority. Non-conveyed patients were more often assessed by ambulance clinicians as presenting non-specific symptoms or symptoms related to psychiatric problems. Low blood glucose levels were highly associated with non-conveyance (adjusted OR (AOR): 15; 95 % CI 11.18 to 20.13), although non-conveyed patients presented abnormal vital signs across all categories of vital signs. Moreover, drugs were more often administered to younger non-conveyed patients. Older patients were more often conveyed and administered drugs once conveyed (AOR: 1.29; 95 % CI 1.07 to 1.56).

CONCLUSIONS: This study shows that non-conveyed patients represent a non-negligible proportion of all patients in contact with ambulance services. In general, most cases of non-conveyance occur at the highest dispatch level, to a large extent involve younger patients, and features problems assessed by ambulance clinicians as non-specific or related to psychiatric symptoms.

Place, publisher, year, edition, pages
2020. Vol. 10, no 7, article id e036659
Keywords [en]
accident & emergency medicine, epidemiology, statistics & research methods
National Category
General Practice
Identifiers
URN: urn:nbn:se:shh:diva-3784DOI: 10.1136/bmjopen-2019-036659PubMedID: 32665389OAI: oai:DiVA.org:shh-3784DiVA, id: diva2:1459306
Available from: 2020-08-19 Created: 2020-08-19 Last updated: 2023-08-28Bibliographically approved

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Löfvenmark, Caroline

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CiteExportLink to record
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