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Epidemiological Determinants of Patient Non-Conveyance to the Hospital in an Emergency Medical Service Environment

Author

Listed:
  • Hassan Farhat

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
    Faculty of Sciences, University of Sfax, Sfax P.O. Box 3000, Tunisia
    Faculty of Medicine “Ibn El Jazzar”, University of Sousse, Sousse P.O. Box 4000, Tunisia)

  • Cyrine Abid

    (Faculty of Medicine, University of Sfax, Sfax P.O. Box 3000, Tunisia)

  • Kawther El Aifa

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar)

  • Padarath Gangaram

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
    Faculty of Health Sciences, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa)

  • Andre Jones

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar)

  • Mohamed Chaker Khenissi

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar)

  • Moncef Khadhraoui

    (Higher Institute of Biotechnology, University of Sfax, Sfax P.O. Box 3038, Tunisia)

  • Imed Gargouri

    (Faculty of Medicine, University of Sfax, Sfax P.O. Box 3000, Tunisia)

  • Loua Al-Shaikh

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar)

  • James Laughton

    (Faculty of Health Sciences, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa)

  • Guillaume Alinier

    (Ambulance Service, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
    School of Health and Social Work, University of Hertfordshire, Hatfield AL10 9AB, UK
    Weill Cornell Medicine-Qatar, Doha P.O. Box 24144, Qatar
    Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK)

Abstract

Background: The increasing prevalence of comorbidities worldwide has spurred the need for time-effective pre-hospital emergency medical services (EMS). Some pre-hospital emergency calls requesting EMS result in patient non-conveyance. Decisions for non-conveyance are sometimes driven by the patient or the clinician, which may jeopardize the patients’ healthcare outcomes. This study aimed to explore the distribution and determinants of patient non-conveyance to hospitals in a Middle Eastern national Ambulance Service that promotes the transportation of all emergency call patients and does not adopt clinician-based non-conveyance decision. Methods: Using R Language, descriptive, bivariate, and binary logistic regression analyses were conducted for 334,392 multi-national patient non-conveyance emergency calls from June 2018 to July 2022, from a total of 1,030,228 calls to which a response unit was dispatched. Results: After data pre-processing, 237,862 cases of patient non-conveyance to hospital were retained, with a monthly average of 41.96% ( n = 8799) of the emergency service demands and a standard deviation of 5.49% ( n = 2040.63). They predominantly involved South Asians (29.36%, n = 69,849); 64.50% ( n = 153,427) were of the age category from 14 to 44 years; 61.22% ( n = 145,610) were male; 74.59% ( n = 177,424) from the urban setting; and 71.28% ( n = 169,552) had received on-scene treatment. Binary logistic regression with full variables and backward methods identified the final models of the determinants of patient non-conveyance decisions with an Akaike information criterion prediction estimator, respectively, of (250,200) and (250,169), indicating no significant difference between both models (Chi-square test; p -value = 0.63). Conclusions: Despite exercising a cautious protocol by encouraging patient transportation to hospital, patient non-conveyance seems to be a problem in the healthcare system that strains the pre-hospital medical response teams’ resources. Policies and regulations should be adopted to encourage individuals to access other primary care centers when required rather than draining emergency services for non-emergency situations.

Suggested Citation

  • Hassan Farhat & Cyrine Abid & Kawther El Aifa & Padarath Gangaram & Andre Jones & Mohamed Chaker Khenissi & Moncef Khadhraoui & Imed Gargouri & Loua Al-Shaikh & James Laughton & Guillaume Alinier, 2023. "Epidemiological Determinants of Patient Non-Conveyance to the Hospital in an Emergency Medical Service Environment," IJERPH, MDPI, vol. 20(14), pages 1-20, July.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:14:p:6404-:d:1197924
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    References listed on IDEAS

    as
    1. Hassan Al-Thani & Ahammed Mekkodathil & Attila J. Hertelendy & Ian Howland & Tim Frazier & Ayman El-Menyar, 2021. "Emergency Medical Services (EMS) Transportation of Trauma Patients by Geographic Locations and In-Hospital Outcomes: Experience from Qatar," IJERPH, MDPI, vol. 18(8), pages 1-13, April.
    2. Hassan N. Moafa & Sander Martijn Job van Kuijk & Dhafer M. Alqahtani & Mohammed E. Moukhyer & Harm R. Haak, 2020. "Disparities between Rural and Urban Areas of the Central Region of Saudi Arabia in the Utilization and Time-Centeredness of Emergency Medical Services," IJERPH, MDPI, vol. 17(21), pages 1-14, October.
    3. Hassan N. Moafa & Sander M. J. van Kuijk & Mohammed E. Moukhyer & Dhafer M. Alqahtani & Harm R. Haak, 2021. "Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia," IJERPH, MDPI, vol. 18(17), pages 1-13, September.
    4. Ragui Assaad & Rana Hendy & Moundir Lassassi & Shaimaa Yassin, 2020. "Explaining the MENA paradox: Rising educational attainment yet stagnant female labor force participation," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 43(28), pages 817-850.
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