Quo vadis, gemeinsames Notfallleitsystem?

Breuer, Florian; Brettschneider, Paul; Poloczek, Stefan; Pommerenke, Christopher; Wolff, Justus; Dahmen, Janosch

doi:10.1007/s10049-022-01073-1

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…This is one of only few studies using a large individual-level secondary EMS dataset in Germany and the first to include all Berlin dispatch protocols from the recent four years. The study design benefits from MPDS implementation in Berlin as an internationally standardised system [ 26 ]. Entry errors can be considered as marginal due to the electronic documentation process.…”

Section: Discussionmentioning

confidence: 99%

“…About 90% of people in Germany are statutory health insured, the others have—with some exceptions of specific coverage—substitutive private health insurance [ 25 ]. The EMS in Berlin, run by the fire department, is responsible for taking emergency calls (phone number 112), dispatching ambulances, and transporting patients with acute conditions to hospitals [ 26 ]. Besides EMS and EDs, an On-Call Medical Service (OCMS) of the association of statutory-health insurance physicians (phone number 116 117) exists, which is meant to replace regular medical practices outside of regular opening hours.…”

Section: Methodsmentioning

confidence: 99%

“…So, it is not there for the very acute cases. In Berlin, about hundred low-acuity EMS calls are being transferred to the OCMS per day [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

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Increasing emergency number utilisation is not driven by low-acuity calls: an observational study of 1.5 million emergency calls (2018–2021) from Berlin

Herr

Bhatia

Breuer

et al. 2023

BMC Med

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Background The Emergency Medical Service (EMS) in Germany is increasingly challenged by strongly rising demand. Speculations about a greater utilisation for minor cases have led to intensive media coverage, but empirical evidence is lacking. We investigated the development of low-acuity calls from 2018 to 2021 in the federal state of Berlin and its correlations with sociodemographic characteristics. Methods We analysed over 1.5 million call documentations including medical dispatch codes, age, location and time using descriptive and inferential statistics and multivariate binary logistic regression. We defined a code list to classify low-acuity calls and merged the dataset with sociodemographic indicators and data on population density. Results The number of emergency calls (phone number 112 in Germany) increased by 9.1% from 2018 to 2021; however, the proportion of low-acuity calls did not increase. The regression model shows higher odds of low-acuity for young to medium age groups (especially for age 0–9, OR 1.50 [95% CI 1.45–1.55]; age 10–19, OR 1.77 [95% CI 1.71–1.83]; age 20–29, OR 1.64 [95% CI 1.59–1.68] and age 30–39, OR 1.40 [95% CI 1.37–1.44]; p < 0.001, reference group 80–89) and for females (OR 1.12 [95% CI 1.1–1.13], p < 0.001). Odds were slightly higher for calls from a neighbourhood with lower social status (OR 1.01 per index unit increase [95% CI 1.0–1.01], p < 0.05) and at the weekend (OR 1.02 [95% CI 1.0–1.04, p < 0.05]). No significant association of the call volume with population density was detected. Conclusions This analysis provides valuable new insights into pre-hospital emergency care. Low-acuity calls were not the primary driver of increased EMS utilisation in Berlin. Younger age is the strongest predictor for low-acuity calls in the model. The association with female gender is significant, while socially deprived neighbourhoods play a minor role. No statistically significant differences in call volume between densely and less densely populated regions were detected. The results can inform the EMS in future resource planning.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Increasing emergency number utilisation is not driven by low-acuity calls: an observational study of 1.5 million emergency calls (2018–2021) from Berlin

Herr

Bhatia

Breuer

et al. 2023

BMC Med

Self Cite

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Regional differences, repeated use, and costs of emergency medical services in Germany

Roessler,

Schulte,

Bobeth

et al. 2024

Med Klin Intensivmed Notfmed

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Background Little is known about regional differences regarding the utilization and costs of emergency medical services (EMS) in Germany. Evidence on characteristics of repeated use of EMS is also scarce. Objectives To compare German federal states regarding the utilization and costs of EMS and to analyze characteristics of repeated EMS use. Materials and methods We used BARMER health insurance data on more than 1.4 million German EMS cases in 2022. We estimated EMS use rates (per 1000 inhabitants) and median reimbursements and costs by EMS type (ground transport with/without emergency physician (EP); helicopter emergency medical services), hospitalization status, and federal state. We applied Poisson regression to estimate incidence rate ratios (IRRs) with 95% confidence intervals (95% CI), capturing relationships between repeated use of EMS and individual characteristics, including care degree and income level. Results Ground transport EMS use rates varied between federal states by more than 2.6-fold without EP (Bavaria: 84.6; Berlin: 223.2) and 2.1-fold with EP (Bremen: 19.1; Saxony: 41.3). Median reimbursement of ground transport with EP was 132% higher in Schleswig-Holstein (€ 1530) compared with Berlin (€ 660). Approximately one-third of all persons used EMS more than once and accounted for two-thirds of all EMS cases. Repeated EMS use was strongly related to care degree (IRR of care degree 5: 3084; 95% CI 3.012–3.158) and low income (IRR: 1.174; 95% CI 1.161–1.189). Conclusions The substantial regional heterogeneity in terms of utilization and costs of EMS calls for a nationwide, consistent regulation of EMS in Germany. Additionally, (outpatient) primary nursing care of persons with severe health impairments and health literacy should be strengthened.

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Editorial

Dahmen,

Reifferscheid

2024

NOTARZT

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Quo vadis, gemeinsames Notfallleitsystem?

Cited by 4 publications

References 25 publications

Increasing emergency number utilisation is not driven by low-acuity calls: an observational study of 1.5 million emergency calls (2018–2021) from Berlin

Increasing emergency number utilisation is not driven by low-acuity calls: an observational study of 1.5 million emergency calls (2018–2021) from Berlin

Regional differences, repeated use, and costs of emergency medical services in Germany

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