Differences between emergency medical services operations with and without patient transport: A retrospective analysis of dispatch center data in a territorial state

Abstract

Background: The use of the emergency medical services (EMS) in Bavaria has been increasing for years. We hypothesized that emergency response without patient transport (RoT) is often an expression of inadequate alert planning. The aim of the study was to describe the differences between the integrated dispatch centers (ILSs) for such operations with regard to the characteristics of transport quotas and ranges according to the reason for deployment as well as times and days of the week. Method: Retrospective cross-sectional study of data from all 26 ILSs in the Free State of Bavaria in 2018. Transport quotas for emergency operations for essential reasons without emergency physician involvement were analyzed comparatively in relation to dispatch center area, time of day, and day of the week. Deployments were categorized as RoT or ambulance deployment with transport (TP). Results: Of 510,145 call-outs, 147,621 (28.9%) were RoT and 362,524 (71.1%) were TP. There were significant regional differences in the transport quotas for all deployment reasons investigated. The highest range among the ILSs was found for the deployment reasons “fire alarm system” (16.8 percentage points), “personal emergency response system” (16.1%), and “heart/circulation” (14.6%). In the morning hours, the number of calls decreases with increasing TP. The fewest RoT took place between 8 and 10 am. The days of the week analysis revealed small differences in the frequency of RoT on Mondays as well as on weekends without planning relevance. Conclusion: We found significant differences in the ranges. This could indicate locally different alert planning specifications or dispatching decisions by the ILS. The control centers probably have considerable potential for controlling and improving resource allocation.