Impact of frequent users on emergency medical services personnel: survey results

Abstract

Background: Frequent users (FUs) increasingly use emergency medical services (EMS) in a short period of time and can thus have a direct influence on the volume and character of operations. For this reason, the aim of this study was to investigate how EMS personnel in Germany perceive FUs. Methods: This was a Germany-wide cross-sectional survey study with EMS personnel. The data were descriptively analyzed by calculating frequencies. Differences regarding FUs in rural and urban areas were analyzed using the Chi2 test and by calculating odds ratios (OR) and associated 95% confidence intervals (95% CI). Results: A total of 1142 EMS personnel (36.69% women, 62.87% men) were included in the study. The two most frequently perceived locations of emergency calls related to FUs were certain private addresses (32.75%) and nursing homes (29.99%), and the most common causes were medical supply problems (44.66%) and intoxications (24.34%). In rural areas, certain private addresses (42.51%) were also the most frequent locations of intervention, whereas in urban areas, certain urban neighborhoods were more dominant (34.94%). FUs had a negative impact on the behavior, mood, and patience of EMS responders. In rural areas, the odds of FUs receiving a careful medical evaluation was lower (OR 0.61 [95% CI 0.48; 0.78]) and patients did not want care because third parties alerted the rescue workers (OR 0.67 [95% CI 0.53; 0.84]). In contrast, in rural areas the odds of FUs rating their symptoms as more threatening than necessary was higher (OR 1.95 [95% CI 1.37; 2.77]) and that an outreach to FUs occurs outside the opening hours of care providers (OR 1.65 [95% CI 1.30; 2.09]). Conclusion: This study shows that frequent users have a negative impact on the mood as well as the working method of EMS responders, and urban–rural differences exist both in this regard and in relation to the most frequent deployment locations.