Telephone Triage for Emergency Patients Reduces Unnecessary Ambulance Use: A Propensity Score Analysis With Population-Based Data in Osaka City, Japan

Abstract

BackgroundTelephone triage service in emergency care has been introduced around the world, but the impact of this service on the emergency medical service (EMS) system has not been fully revealed. The aim of this study was to evaluate the effect of telephone triage service for emergency patients on decreasing unnecessary ambulance use by analysis with propensity score (PS) matching.MethodsThis study was a retrospective observational study, and the study period was the 4 years from January 2016 to December 2019. We included cases for which ambulances were dispatched from the Osaka Municipal Fire Department (OMFD). The primary outcome of this study was unnecessary ambulance use. We calculated a PS by fitting a logistic regression model to adjust for 10 variables that existed before use of the telephone triage service. To ensure the robustness of this analysis, we used not only PS matching but also a multivariable logistic regression model and regression model with PS as a covariate.ResultsThis study included 868,548 cases, of which 8,828 (1.0%) used telephone triage services and 859,720 (99.0%) did not use this service. Use of the telephone triage service was inversely associated with the occurrence of unnecessary ambulance use in multivariate logistic regression model (adjusted OR 0.453, 95% CI 0.405–0.506) and multivariate logistic regression model with PS as a covariate (adjusted OR 0.514, 95% CI 0.460–0.574). In the PS matching model, we also revealed same results (crude OR 0.487, 95% CI 0.425–0.588).ConclusionsIn this study, we were able to statistically evaluate the effectiveness of telephone triage service already in use by the public using the statistical method with PS. As a result, it was revealed that the use of a telephone triage service was associated with a lower proportion of unnecessary ambulance use in a metropolitan area of Japan.

Awareness and information resources concerning emergency telephone consultation services in older adults in an aging community in Japan

“…In particular, from the end of 2021 to January 30, 2022, the number of new infections in Japan increased to 502 845 cases/week owing to greater interactions between people during the year-end holiday season and New Year's celebrations. 3 During this period, if the number of infected residents at the nursing home increased, the nursing home took the following actions: restricting related organizations from entering the facility, restricting visits by family members, restricting meal consumption to private rooms, and canceling group recreation. These preventive actions may have interrupted social interaction and social activity among residents.…”

“…Japan has emergency telephone consultation (ETC) services, a telephone-based triage system that enables community-dwelling residents to consult with medical professionals about their need for emergency care, such as calling for an ambulance or visiting the emergency department for sudden illness or injuries. [1][2][3] ETC services are known to reduce unnecessary ambulance use through interactive communication with medical professionals. 2,3 Although older adults are prone to needing emergency care, they do not frequently use ETC services.…”

“…[1][2][3] ETC services are known to reduce unnecessary ambulance use through interactive communication with medical professionals. 2,3 Although older adults are prone to needing emergency care, they do not frequently use ETC services. 1 This may suggest that ETC services are not widespreadly percieved among older adults; however, the actual situation is unclear.…”

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Patient compliance to sublingual immunotherapy for mite-induced allergic rhinitis: A retrospective study

“…The age groups were further divided into 2 categories: children (≤14 years old) and adolescents/adults (>14 years old). 15 , 16 All the patients in this study were diagnosed with AR according to the clinical guidelines. 17 The patients presented with a medical history consistent with HDM allergy and demonstrated sensitization to Dermatophagoides farinae ( Der f ) and/or Dermatophagoides pteronyssinus ( Der p ), which was confirmed by positive results from skin-prick tests (≥++) and/or the serological detection of specific IgE antibodies (≥0.7 kU A /L).…”