An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands
Abstract Background Non-conveyance is an increasing part of ambulance care and has to be safe. One of the indicators to measure safety is an ambulance re-contact within 72 h. However, solely measuring the percentage of re-contacts has limited validity as it lacks insight in actual reasons of an ambu...
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| Format: | Article |
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BMC
2025-02-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s13049-025-01332-3 |
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| author | Susanne E. de Loor Tessa Verheij Thomas Karol Franciscus G. M. H. M. Cuppen Frits van Dijk Femke Goldstein Joyce Janssen Remco H. A. Ebben |
| author_facet | Susanne E. de Loor Tessa Verheij Thomas Karol Franciscus G. M. H. M. Cuppen Frits van Dijk Femke Goldstein Joyce Janssen Remco H. A. Ebben |
| author_sort | Susanne E. de Loor |
| collection | DOAJ |
| description | Abstract Background Non-conveyance is an increasing part of ambulance care and has to be safe. One of the indicators to measure safety is an ambulance re-contact within 72 h. However, solely measuring the percentage of re-contacts has limited validity as it lacks insight in actual reasons of an ambulance re-contact. Therefore, the aim of our study was to analyze the incidence, reasons and outcomes of ambulance re-contacts within 72 h after non-conveyance. Methods We conducted a one year (2022) retrospective study in one EMS region in the Netherlands. Medical records of all non-conveyance runs with a re-contact were analyzed using a framework to categorize re-contact reasons in illness-related, patient-related, professional-related, and unrelated. Re-contact outcomes were measured in terms of (non-)conveyance and mortality. Results 585/13.879 (4.2%) non-conveyance runs had a re-contact within 72 h. 547/585 (93.5%) re-contacts could be categorized with the framework. Re-contacts were related to the illness (n = 267, 48.8%), the patient (n = 130, 23.8%), the professional (n = 106, 19.4%) and unrelated (n = 44, 8.0%). Four subreasons accounted for 68.5% of reasons for re-contacts: progression of disease (19.4%), recurrent disease process/exacerbation (18.6%), reassessment and ambulance request by another medical professional (15.9%), and psychiatric disorder and/or substance abuse (14.6%). 403/547 (73.7%) patients with a re-contact were conveyed to the hospital. Mortality rate for patients with a re-contact was 0.5%. Conclusions Re-contact incidence after non-conveyance is relatively low, with a very small part of re-contacts related to ambulance care professionals making errors in diagnosis or treatment. Combined with low re-contact mortality, this indicates safe non-conveyance decisions. Re-contacts as quality indicator cover a variety of reasons, with almost half of the re-contacts being related to illness. Four subcategories accounted for the majority of all reasons for re-contacts: progression of disease, recurrent disease process/exacerbation, reassessment and ambulance request by another medical professional, and psychiatric disorder and/or substance abuse. Three-quarters of the patients were conveyed, although more re-contacts due to patient related reasons ended in non-conveyance again. |
| format | Article |
| id | doaj-art-ae7241996fcb49f09abd44e2adfaea14 |
| institution | Kabale University |
| issn | 1757-7241 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj-art-ae7241996fcb49f09abd44e2adfaea142025-02-02T12:40:14ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-02-013311910.1186/s13049-025-01332-3An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the NetherlandsSusanne E. de Loor0Tessa Verheij1Thomas Karol2Franciscus G. M. H. M. Cuppen3Frits van Dijk4Femke Goldstein5Joyce Janssen6Remco H. A. Ebben7Emergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenEmergency Medical Service, Public Health and Safety Region Gelderland-MiddenAbstract Background Non-conveyance is an increasing part of ambulance care and has to be safe. One of the indicators to measure safety is an ambulance re-contact within 72 h. However, solely measuring the percentage of re-contacts has limited validity as it lacks insight in actual reasons of an ambulance re-contact. Therefore, the aim of our study was to analyze the incidence, reasons and outcomes of ambulance re-contacts within 72 h after non-conveyance. Methods We conducted a one year (2022) retrospective study in one EMS region in the Netherlands. Medical records of all non-conveyance runs with a re-contact were analyzed using a framework to categorize re-contact reasons in illness-related, patient-related, professional-related, and unrelated. Re-contact outcomes were measured in terms of (non-)conveyance and mortality. Results 585/13.879 (4.2%) non-conveyance runs had a re-contact within 72 h. 547/585 (93.5%) re-contacts could be categorized with the framework. Re-contacts were related to the illness (n = 267, 48.8%), the patient (n = 130, 23.8%), the professional (n = 106, 19.4%) and unrelated (n = 44, 8.0%). Four subreasons accounted for 68.5% of reasons for re-contacts: progression of disease (19.4%), recurrent disease process/exacerbation (18.6%), reassessment and ambulance request by another medical professional (15.9%), and psychiatric disorder and/or substance abuse (14.6%). 403/547 (73.7%) patients with a re-contact were conveyed to the hospital. Mortality rate for patients with a re-contact was 0.5%. Conclusions Re-contact incidence after non-conveyance is relatively low, with a very small part of re-contacts related to ambulance care professionals making errors in diagnosis or treatment. Combined with low re-contact mortality, this indicates safe non-conveyance decisions. Re-contacts as quality indicator cover a variety of reasons, with almost half of the re-contacts being related to illness. Four subcategories accounted for the majority of all reasons for re-contacts: progression of disease, recurrent disease process/exacerbation, reassessment and ambulance request by another medical professional, and psychiatric disorder and/or substance abuse. Three-quarters of the patients were conveyed, although more re-contacts due to patient related reasons ended in non-conveyance again.https://doi.org/10.1186/s13049-025-01332-3Non-conveyanceEmergency medical services [MeSH]Patient safety [MeSH] |
| spellingShingle | Susanne E. de Loor Tessa Verheij Thomas Karol Franciscus G. M. H. M. Cuppen Frits van Dijk Femke Goldstein Joyce Janssen Remco H. A. Ebben An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Non-conveyance Emergency medical services [MeSH] Patient safety [MeSH] |
| title | An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands |
| title_full | An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands |
| title_fullStr | An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands |
| title_full_unstemmed | An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands |
| title_short | An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands |
| title_sort | analysis of ambulance re contacts after non conveyance a retrospective cohort study in the netherlands |
| topic | Non-conveyance Emergency medical services [MeSH] Patient safety [MeSH] |
| url | https://doi.org/10.1186/s13049-025-01332-3 |
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