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Background <p>Emergency department (ED) crowding is a major concern across Europe. This study compares EMS-transported and walk-in patients across EDs in different settlement types with regard to care-seeking behaviour, presenting complaints and awareness of alternative care pathways.</p> Methods <p>We conducted a prospective, multicentre survey among patients in 20 EDs in Berlin and Bavaria (Mar–Oct 2024). A tablet-based questionnaire captured sociodemographics, presenting complaints, perceived urgency and health-care utilisation. EMS and self-referred patients (walk-ins) were compared using χ² and Mann–Whitney U-tests. Multivariable logistic models examined predictors of EMS use and attendance at predominantly urban versus intermediate EDs.</p> Results <p>Of 9,719 patients, 2,641 (27.2%) arrived by EMS. EMS patients were older and more likely to attend predominantly urban EDs. They had more often cardio-respiratory or neurological complaints, whereas pain predominated in walk-ins. Prior outpatient contact was less common among EMS patients (29.3%). In adjusted regional analyses, injury-related presentations were more common in predominantly urban EDs (20.5% vs. 26.3%; <i>p</i> = 0.003), while cardio-respiratory and abdominal complaints showed no differences. Awareness of national on-call service number (116117) was associated with higher odds of predominantly urban attendance.</p> Conclusions <p>EMS patients differ from walk-ins in age, presentation and care-seeking. Differences between regions in case-mix and pre-hospital decision-making suggest that strategies to improve emergency care coordination may benefit from region-sensitive approaches. Whether integration of structured telephone advice (116117) and digital self-assessment tools with EMS dispatch can contribute to more appropriate resource allocation warrants prospective evaluation.</p> Registration <p>DRKS00033986; DRKS00034961.</p>

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Comparing emergency medical service and walk-in patients in German emergency departments: a prospective multicentre survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月14日

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  • Sarah Oslislo,
  • Kalina Witt,
  • Edgar Steiger,
  • Johannes Hagelskamp,
  • Dominik von Stillfried,
  • Gökhan Katipoglu,
  • Christian Pfeiffer,
  • Michael Dommasch,
  • Matthias Klein,
  • Rajan Somasundaram,
  • Christian Wrede,
  • Michael Bayeff-Filloff,
  • Viktoria Bogner-Flatz,
  • Steffen Herdtle,
  • Markus Zimmermann

摘要

Background

Emergency department (ED) crowding is a major concern across Europe. This study compares EMS-transported and walk-in patients across EDs in different settlement types with regard to care-seeking behaviour, presenting complaints and awareness of alternative care pathways.

Methods

We conducted a prospective, multicentre survey among patients in 20 EDs in Berlin and Bavaria (Mar–Oct 2024). A tablet-based questionnaire captured sociodemographics, presenting complaints, perceived urgency and health-care utilisation. EMS and self-referred patients (walk-ins) were compared using χ² and Mann–Whitney U-tests. Multivariable logistic models examined predictors of EMS use and attendance at predominantly urban versus intermediate EDs.

Results

Of 9,719 patients, 2,641 (27.2%) arrived by EMS. EMS patients were older and more likely to attend predominantly urban EDs. They had more often cardio-respiratory or neurological complaints, whereas pain predominated in walk-ins. Prior outpatient contact was less common among EMS patients (29.3%). In adjusted regional analyses, injury-related presentations were more common in predominantly urban EDs (20.5% vs. 26.3%; p = 0.003), while cardio-respiratory and abdominal complaints showed no differences. Awareness of national on-call service number (116117) was associated with higher odds of predominantly urban attendance.

Conclusions

EMS patients differ from walk-ins in age, presentation and care-seeking. Differences between regions in case-mix and pre-hospital decision-making suggest that strategies to improve emergency care coordination may benefit from region-sensitive approaches. Whether integration of structured telephone advice (116117) and digital self-assessment tools with EMS dispatch can contribute to more appropriate resource allocation warrants prospective evaluation.

Registration

DRKS00033986; DRKS00034961.