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Background <p>Efficient and patient-centered emergency care requires early control of patient flow. It is unclear whether this is already possible in the prehospital phase by emergency medical services (EMS) and whether this can contribute to relieving pressure on emergency departments (EDs).</p> Objectives <p>To examine the correlation between prehospital triage categories by EMS personnel and patient admission/discharge after treatment in the ED, and to assess the use of hospital resources for patients who remained outpatients.</p> Methods <p>Retrospective analysis of routine preclinical and clinical data from all patients presenting to the ED of a&#xa0;university hospital by EMS over a&#xa0;2-week period. Analyses were performed descriptively and using the Mann–Whitney&#xa0;U test and the χ<sup>2</sup> test. Positive and negative predictive values were also calculated.</p> Results <p>During the observation period, 570 EMS patients were seen in the ED, of whom 307 (53.9%) remained as outpatients. For 309 (54.2%) of the patients, the triage category assigned by the EMS corresponded to the type of subsequent care (outpatient/inpatient); in 249 cases (43.7%) the need for inpatient care was overestimated. In addition, 262 patients (85.3%) received at least one diagnostic or therapeutic resource prior to discharge, the most common being X‑rays (118/38.4%).</p> Conclusion <p>In only about half of the cases was the EMS personnel’s prognosis consistent with the subsequent decision to admit or discharge the patient from the ED. Patients who remained as outpatients tended to require further diagnostic and therapeutic resources. Therefore, direct transfer of EMS patients to alternative care structures seems risky in the current environment.</p>

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Eignung rettungsdienstlicher Sichtungskategorien zur Vorhersage des ambulanten oder stationären Weiterversorgungsbedarfs: eine explorative Analyse von Routinedaten

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  • 发表日期：

    2025年6月25日

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  • Torben Brod,
  • Uta Hillebrand,
  • Christoph Schröder,
  • Andreas Flemming,
  • Nils Schneider,
  • Tanja Schleef

摘要

Background

Efficient and patient-centered emergency care requires early control of patient flow. It is unclear whether this is already possible in the prehospital phase by emergency medical services (EMS) and whether this can contribute to relieving pressure on emergency departments (EDs).

Objectives

To examine the correlation between prehospital triage categories by EMS personnel and patient admission/discharge after treatment in the ED, and to assess the use of hospital resources for patients who remained outpatients.

Methods

Retrospective analysis of routine preclinical and clinical data from all patients presenting to the ED of a university hospital by EMS over a 2-week period. Analyses were performed descriptively and using the Mann–Whitney U test and the χ2 test. Positive and negative predictive values were also calculated.

Results

During the observation period, 570 EMS patients were seen in the ED, of whom 307 (53.9%) remained as outpatients. For 309 (54.2%) of the patients, the triage category assigned by the EMS corresponded to the type of subsequent care (outpatient/inpatient); in 249 cases (43.7%) the need for inpatient care was overestimated. In addition, 262 patients (85.3%) received at least one diagnostic or therapeutic resource prior to discharge, the most common being X‑rays (118/38.4%).

Conclusion

In only about half of the cases was the EMS personnel’s prognosis consistent with the subsequent decision to admit or discharge the patient from the ED. Patients who remained as outpatients tended to require further diagnostic and therapeutic resources. Therefore, direct transfer of EMS patients to alternative care structures seems risky in the current environment.