An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands

Abstract Background Non-conveyed patients are a significant population within ambulance care. To gain insight in patient safety for this population, ambulance re-contacts within 72 h are monitored. However, little is known about the background of these non-conveyance cases with a re-contact. This st...

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Main Authors: Renate F. Speijers, Remco H. A. Ebben, Ties Eikendal, Lobke Ruijs, Franciscus G. M. H. M. Cuppen, Rien de Vos
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Online Access:https://doi.org/10.1186/s13049-025-01365-8
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author Renate F. Speijers
Remco H. A. Ebben
Ties Eikendal
Lobke Ruijs
Franciscus G. M. H. M. Cuppen
Rien de Vos
author_facet Renate F. Speijers
Remco H. A. Ebben
Ties Eikendal
Lobke Ruijs
Franciscus G. M. H. M. Cuppen
Rien de Vos
author_sort Renate F. Speijers
collection DOAJ
description Abstract Background Non-conveyed patients are a significant population within ambulance care. To gain insight in patient safety for this population, ambulance re-contacts within 72 h are monitored. However, little is known about the background of these non-conveyance cases with a re-contact. This study aims to investigate the incidence of re-contacts, analyse characteristics, and identify factors associated with re-contacts following non-conveyance. Methods This was a retrospective cohort study of all non-conveyance cases and all associated re-contacts in two EMS regions in the Netherlands, Gelderland-Zuid and Gelderland-Midden. Data was collected from 1 January 2022 till 31 December 2022. Characteristics of non-conveyance cases with and without a re-contact within 72 h were compared and differences were analysed univariately. Logistic regression analyses were used to quantify bivariate and multivariable associations between characteristics of non-conveyance cases and EMS re-contact within 72 h. Associations are expressed in odds ratios with 95% confidence interval. Results In the analysis of 19.563 cases, the overall incidence for an EMS re-contact within 72 h was 5.0% (N = 984/19.563), with 3.4% (669/19.563) within 24 h, 1.0% (195/19.563) within 24–48 h and 0.6% (120/19.563) within 48–72 h. In a subset of 13.010 complete cases, significant multivariable associations were observed between re-contacts and age > 65 (OR 2.15, CI 1.82–2.53), male gender (OR 1.39, CI 1.18–1.63), and medical complaints related to specialism 'Pulmonology' (OR 2.45, CI 1.67–3.64), 'Neurology' (OR 1.81, CI 1.28–2.59) and 'Traumatology/surgery’ (OR 0.51, CI 0.34–0.76). Other significant associations were noted with night-time cases (OR 1.49, CI 1.21–1.82) and cases in which consultation or handover to a general practitioner occurred (OR 1.25, CI 1.06–1.47). Conclusions A low overall incidence of EMS re-contacts indicates that non-conveyance within the EMS system is relatively safe. The likelihood of re-contact is higher for age above 65, male gender, and medical complaints within the specialisms of 'Pulmonology' and 'Neurology'. Non-conveyance cases that involve consultation or handover to a GP and cases occurring at night are also more likely to have a re-contact. The findings inform non-conveyance decision-making, and could serve as a starting point to adapt EMS curricula, and develop guidelines and protocols. This may fuel the enhancement of non-conveyance decision-making, thereby improving the quality of healthcare within the EMS system.
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spelling doaj-art-bc29f4d9eb234472addc64270b5a04d82025-08-20T02:28:11ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-04-0133111110.1186/s13049-025-01365-8An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the NetherlandsRenate F. Speijers0Remco H. A. Ebben1Ties Eikendal2Lobke Ruijs3Franciscus G. M. H. M. Cuppen4Rien de Vos5Emergency Medical Service, Public Health and Safety Region Gelderland-ZuidEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-ZuidEmergency Medical Service, Public Health and Safety Region Gelderland-ZuidEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenDepartment of Education and Training, Amsterdam University Medical CenterAbstract Background Non-conveyed patients are a significant population within ambulance care. To gain insight in patient safety for this population, ambulance re-contacts within 72 h are monitored. However, little is known about the background of these non-conveyance cases with a re-contact. This study aims to investigate the incidence of re-contacts, analyse characteristics, and identify factors associated with re-contacts following non-conveyance. Methods This was a retrospective cohort study of all non-conveyance cases and all associated re-contacts in two EMS regions in the Netherlands, Gelderland-Zuid and Gelderland-Midden. Data was collected from 1 January 2022 till 31 December 2022. Characteristics of non-conveyance cases with and without a re-contact within 72 h were compared and differences were analysed univariately. Logistic regression analyses were used to quantify bivariate and multivariable associations between characteristics of non-conveyance cases and EMS re-contact within 72 h. Associations are expressed in odds ratios with 95% confidence interval. Results In the analysis of 19.563 cases, the overall incidence for an EMS re-contact within 72 h was 5.0% (N = 984/19.563), with 3.4% (669/19.563) within 24 h, 1.0% (195/19.563) within 24–48 h and 0.6% (120/19.563) within 48–72 h. In a subset of 13.010 complete cases, significant multivariable associations were observed between re-contacts and age > 65 (OR 2.15, CI 1.82–2.53), male gender (OR 1.39, CI 1.18–1.63), and medical complaints related to specialism 'Pulmonology' (OR 2.45, CI 1.67–3.64), 'Neurology' (OR 1.81, CI 1.28–2.59) and 'Traumatology/surgery’ (OR 0.51, CI 0.34–0.76). Other significant associations were noted with night-time cases (OR 1.49, CI 1.21–1.82) and cases in which consultation or handover to a general practitioner occurred (OR 1.25, CI 1.06–1.47). Conclusions A low overall incidence of EMS re-contacts indicates that non-conveyance within the EMS system is relatively safe. The likelihood of re-contact is higher for age above 65, male gender, and medical complaints within the specialisms of 'Pulmonology' and 'Neurology'. Non-conveyance cases that involve consultation or handover to a GP and cases occurring at night are also more likely to have a re-contact. The findings inform non-conveyance decision-making, and could serve as a starting point to adapt EMS curricula, and develop guidelines and protocols. This may fuel the enhancement of non-conveyance decision-making, thereby improving the quality of healthcare within the EMS system.https://doi.org/10.1186/s13049-025-01365-8Non-conveyanceEmergency medical servicesAmbulancesRe-contacts
spellingShingle Renate F. Speijers
Remco H. A. Ebben
Ties Eikendal
Lobke Ruijs
Franciscus G. M. H. M. Cuppen
Rien de Vos
An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Non-conveyance
Emergency medical services
Ambulances
Re-contacts
title An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands
title_full An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands
title_fullStr An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands
title_full_unstemmed An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands
title_short An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands
title_sort analysis of characteristics and associated factors for re contacts after ems non conveyance a retrospective cohort study in the netherlands
topic Non-conveyance
Emergency medical services
Ambulances
Re-contacts
url https://doi.org/10.1186/s13049-025-01365-8
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