Trends in fall-related encounters and predictors of non-transport at a US Emergency Medical Services Agency
| Autor: | Hannah T. Neprash, Andrew C. Stevens, Lori L. Boland, Diana Jin, Christie L Traczyk, Nathan D. Shippee, Jessica N Jeruzal |
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| Rok vydání: | 2021 |
| Předmět: |
Emergency Medical Services
Sociology and Political Science business.industry Health Policy Ambulances Public Health Environmental and Occupational Health Retrospective cohort study Logistic regression United States Odds Falling (accident) Increased risk Logistic Models Agency (sociology) medicine Ambulance service Emergency medical services Humans medicine.symptom business Social Sciences (miscellaneous) Demography Aged Retrospective Studies |
| Zdroj: | Healthsocial care in the communityREFERENCES. 30(5) |
| ISSN: | 1365-2524 |
| Popis: | Non-transport to a hospital after emergency medical services (EMS) encounters for falls is common. However, incident factors associated with non-transport have not been well studied, especially beyond older adults. The objectives of this study are to (1) describe trends in fall-related EMS utilisation among adult patients from 2010 to 2018; (2) describe incident characteristics by age; and (3) identify incident factors associated with non-transport following a fall. This retrospective observational study includes prehospital clinical records data on falls from a large ambulance service in Minnesota, USA. Multivariable logistic regression was used to assess the independent association between non-transport and the following factors: sex, age, race, previous fall-related EMS encounter, incident location and primary impression. Of 62,835 fall-related encounters studied, 14.7% (9,245) did not result in transport by EMS. Fall calls were less common among younger people and the location and medical conditions primarily treated by an EMS provider during a 9-1-1 call differed greatly from those occurring among patients 65 and older. Factors most strongly associated with an increased risk of non-transport in the multivariable model were a primary impression of 'No apparent illness/injury' (OR = 34.5, 95% CI = 30.7-38.7), falling in a public location (OR = 2.09, CI = 1.96-2.22) and having had a fall-related EMS encounter during the prior year (OR = 1.15, CI = 1.1-1.2). Falls that occur in public locations, in patients with a previous fall, or result in no clinical detection of apparent illness or injury have a significantly increased odds of non-transport. Non-transport fall incidents in the United States require significant agency resources. Knowledge about the incident factors associated with non-transport calls is informative for development of alternative models for prehospital care delivery and initiatives to better serve patients. |
| Databáze: | OpenAIRE |
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