The Danish prehospital emergency healthcare system and research possibilities

Lindskou, Tim Alex; Mikkelsen, Søren; Christensen, Erika Frischknecht; Hansen, Poul Anders; Jørgensen, Gitte; Hendriksen, Ole Mazur; Kirkegaard, Hans; Berlac, Peter Anthony; Søvsø, Morten Breinholt

doi:10.1186/s13049-019-0676-5

Cited by 113 publications

(141 citation statements)

References 18 publications

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“…Calls to the national emergency number 1-1-2 concerning acute health problems are redirected to EMCC, where the nurses/paramedics use a criteriabased dispatch protocol to assess the level of urgency and the most adequate response. 1,2 We considered OOH as 4 P.M to 8 A.M on workdays and all hours on weekends and public holidays (GPC hours). Danish health care is tax-financed and free of charge, including the EMS and OOH-PC services.…”

Section: Settingmentioning

confidence: 99%

“…Even though the EMS and many OOH-PC services use telephone triage to assess the most adequate response to the patient's condition, the patient or bystander makes the initial choice of contacting a service and which service to contact. [1][2][3] So far, studies on patient characteristics associated with contacting an acute health care setting have either included patients contacting EMS or OOH-PC and mostly focus has been on inappropriate or recurrent use. [4][5][6][7][8] However, possible overlaps in the EMS and OOH-PC patient populations have been observed; some patients in need of acute care contact OOH-PC and some patients with non-specific complaints perhaps more suitable for OOH-PC contact EMS.…”

Section: Introductionmentioning

confidence: 99%

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<p>Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens</p>

Søvsø¹,

Bech²,

Christensen³

et al. 2020

CLEP

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Background: Out-of-hours (OOH) health care services are often divided into emergency medical services (EMS) and OOH primary care (OOH-PC). EMS and many OOH-PC use telephone triage, yet the patient still makes the initial choice of contacting a service and which service. Sociodemographic characteristics are associated with help-seeking. Yet, differences in characteristics for EMS and OOH-PC patients have not been investigated in any large-scale cohort studies. Such knowledge may contribute to organizing OOH services to match patient needs. Thus, in this study we aimed to explore which sociodemographic patient characteristics were associated with utilizing OOH health care and to explore which sociodemographic characteristics were associated with EMS or OOH-PC contact. Methods: A population-based observational cohort study of inhabitants in two regions (North Denmark Region and Capital Region of Copenhagen) with or without contact to OOH services during 2016 was conducted. Associations between sociodemographic characteristics and OOH contacts (and EMS versus OOH-PC contact) were evaluated by regression analyses. Results: We identified 619,857 patients with OOH contact. Female sex (IRR=1.16 (95% CI: 1.16-1.17)), non-western ethnicity (IRR=1.02 (95% CI: 1.01-1.02)), living alone (IRR=1.08 (95% CI: 1.08-1.09)), age groups ≥81 years (IRR=2.00 (95% CI: 1.98-2.02)) and 0-18 years (IRR=1.66 (95% CI: 1.66-1.67)) and low income (IRR=1.41 (95% CI: 1.40-1.42)) were more likely to contact OOH health care compared to males, Danish ethnicity, citizens cohabitating, age 31-65 years and high income. Disability pensioners more often contacted OOH care (IRR=1.79 (95% CI: 1.77-1.81) compared to employees. Old age (≥81 years) (OR=3.21 (95% CI: 3.13-3.30)), receiving cash benefits (OR=2.45 (95% CI: 2.36-2.54)), low income (OR=1.76 (95% CI: 1.72-1.81)) and living alone (OR=1.40 (95% CI: 1.37-1.42)) were all associated with EMS contacts rather than OOH-PC contacts. Conclusion: Several sociodemographic factors were associated with contacting a health care service outside office hours and with contacting EMS rather than OOH-PC. Old age, low income, low education and low socioeconomic status were of greatest importance.

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Section: Settingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens</p>

Søvsø¹,

Bech²,

Christensen³

et al. 2020

CLEP

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“…Approximately half of the confirmed cases were in the Capital Region of Denmark (9). The Danish EMS system is organized into five regions with similar structures serving ambulances, physician staff vehicles and emergency medical dispatch centers (EMDC) (10). The Capital Region of Denmark, Copenhagen, has 1.8 million inhabitants served by the Copenhagen EMS.…”

Section: Introductionmentioning

confidence: 99%

Strategies to Handle Increased Demand in the COVID-19 Crisis: A Coronavirus EMS Support Track and a Web-Based Self-Triage System

Jensen¹,

Holgersen²,

Jespersen³

et al. 2020

Prehospital Emergency Care

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Background: In emergencies, such as the COVID-19 pandemic, there is an increased need for contact with emergency medical services (EMS), and call volume might surpass capacity. The Copenhagen EMS operates two telephone line the 1-1-2 emergency number and the 1813 medical helpline. A separate coronavirus support track was implemented on the 1813 medical helpline and a web-based self-triage (web triage) system was created to reduce non-emergency call volume. The aim of this paper is to present call volume and the two measures implemented to handle the increased call volume to the Copenhagen EMS. Methods: This is a cross sectional observational study. Call volume and queue time is presented in the first month of the COVID-19 pandemic (27th

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“…Some crowding can be reduced by better integration of community, ambulance and hospital information systems. Experience from Denmark and the Netherlands has shown that primary care and advice lines can have an effective role in providing alternative services and that this can reduce ED attendances 7 8. Lower acuity patients should be offered responsive alternatives to ED care.…”

mentioning

confidence: 99%