Einfluss des sozioökonomischen Status auf Art und Häufigkeit notärztlicher Einsätze

Living in a neighbourhood with a general lower socioeconomic status (SES) may be linked to unfavourable health consequences. Although Germany has a universal health care system, emergency medicine is increasingly the first point of contact for individuals with limited access to regular healthcare facilities. The aim of this study was to examine the relationship between the socioeconomic status of patients and the rates of emergency medical service (EMS) utilization, the initial diagnoses made by the EMS physician in the field, and the severity of the illness of patients.

This retrospective cohort study was based on the physicians’ routine data documentation of the Jena EMS between January and December 2019. The risk factor SES was based on the neighbourhood level of SES. Patients living in neighbourhoods with a special developmental need (based on the risk of poverty, the population of immigrants, and housing security, defined by the City Council of Jena) were attributed a less favourable SES. The primary outcome of interest was the mission (dispatch) rates of EMS physicians, the diagnoses by the EMS physician in the field, and the severity of illness or injury. The results of all outcomes were adjusted for age and gender.

The mission rate of the EMS was 33% significantly higher in areas with a less favourable neighbourhood SES (adjusted odds ratio [OR] 1.33; 95% confidence interval [CI] 1.25–1.42). Psychiatric disorders were 63% more likely (OR 1.63; 95% CI 1.26–2.10) and pulmonary disorders were 37% more likely (OR 1.37; 95% CI 1.06–1.80) for patients with a less favourable neighbourhood SES than for patients with a higher neighbourhood SES. There was no significant association between the severity of the emergencies and SES.

A lower neighbourhood SES is significantly associated with an increased demand for EMS. A higher frequency of psychiatric and pulmonary emergencies may contribute to this observation. Our results may be explained by a heightened healthcare burden and diminished access to medical services in communities characterized by less favourable socioeconomic status. Further studies should confirm and elucidate these results and also explore strategies to mitigate socioeconomic inequalities in health, ultimately alleviating the burden on EMS and emergency departments