Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review
Introduction: The South African (SA) demand for emergency care is increasing, placing more strain on the emergency medical services (EMS) and the larger healthcare system. However, not all patients who call EMS require conveyance to hospital. It is intuitive that the increase in ambulance responses...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Division of General Surgery
2024
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613282247901185 |
|---|---|
| access_status_str | Open Access |
| author | Alsufayan, Mohammed |
| author2 | Stassen, Willem |
| author_browse | Alsufayan, Mohammed Stassen, Willem |
| author_facet | Stassen, Willem Alsufayan, Mohammed |
| author_sort | Alsufayan, Mohammed |
| collection | Thesis |
| description | Introduction: The South African (SA) demand for emergency care is increasing, placing more strain on the emergency medical services (EMS) and the larger healthcare system. However, not all patients who call EMS require conveyance to hospital. It is intuitive that the increase in ambulance responses has also increased the probability for non-conveyance. By determining the variables associated with non-conveyance, EMS resource utilisation can be adjusted accordingly. Local data on the phenomenon is lacking, however, international data suggests that respiratory complaints are common causes for responses resulting in non-conveyance. The aim of this study is to determine the variables that are associated with the nonconveyance of patients with respiratory complaints serviced by the Provincial Government Western Cape (PGWC) EMS, SA. Methods: A retrospective chart review was conducted using data from the PGWC EMS computer aided dispatch (CAD) and electronic patient care reports (ePCR). Data were collected over a one-year period (1 October 2018 - 30 September 2019). All records where the emergency was a respiratory complaint, and the ambulance response ended in nonconveyance were included. The rate of non-conveyance was determined using descriptive analysis. Logistic regression was performed to evaluate factors that affect the likelihood of non-conveyance of respiratory complaints. Results: Out of 33 295 total respiratory complaints, the median patient age was 46 years. Males represented 50.2%(n = 16702) of the sample. There were no significant differences between the age and gender of those who were and were not conveyed. Of the total, 4.48%(n = 1493) were not conveyed to the hospital. Of the non-conveyed calls, 73.34%(n = 1081) were assigned a priority level 1 at dispatch and the remainder were priority 2. The majority, 45.16% (n = 504), of cases had a final triage code of yellow, followed by 31% (n = 356) coded green. Following multivariate regression, the following variables increased the odds of nonconveyance: Green triage (OR 2.04; 95% CI 1.77-2.36; p<0.01), weekends (OR 1.27; 95% CI 1.12-1.44; p<0.01), and nebulisation on scene (OR 1.47; 95% CI 1.23-1.74; p<0.01). Conversely, dispatch priority 2 (less urgent; OR 0.66; 95% CI 0.57-0.76; p<0.01), orange triage (OR 0.68; 95% CI 0.58-0.80; p<0.01), red triage (OR 0.22; 95% CI 0.13-0.37; p<0.01), and oxygen administration (OR 0.52, 95% CI 0.41-0.67; p<0.01) were all associated with decreased odds of non-conveyance. Conclusion: Several variables are associated with the non-conveyance of respiratory complaint patients seen to by PGWC EMS. Future research focusing on the predictors for ambulance non-conveyance could lead to raised efficiency and minimisation in operational expenses, and provider fatigue amongst others. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39189 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:40.116Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39189 Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review Alsufayan, Mohammed Stassen, Willem Emergency Medicine Introduction: The South African (SA) demand for emergency care is increasing, placing more strain on the emergency medical services (EMS) and the larger healthcare system. However, not all patients who call EMS require conveyance to hospital. It is intuitive that the increase in ambulance responses has also increased the probability for non-conveyance. By determining the variables associated with non-conveyance, EMS resource utilisation can be adjusted accordingly. Local data on the phenomenon is lacking, however, international data suggests that respiratory complaints are common causes for responses resulting in non-conveyance. The aim of this study is to determine the variables that are associated with the nonconveyance of patients with respiratory complaints serviced by the Provincial Government Western Cape (PGWC) EMS, SA. Methods: A retrospective chart review was conducted using data from the PGWC EMS computer aided dispatch (CAD) and electronic patient care reports (ePCR). Data were collected over a one-year period (1 October 2018 - 30 September 2019). All records where the emergency was a respiratory complaint, and the ambulance response ended in nonconveyance were included. The rate of non-conveyance was determined using descriptive analysis. Logistic regression was performed to evaluate factors that affect the likelihood of non-conveyance of respiratory complaints. Results: Out of 33 295 total respiratory complaints, the median patient age was 46 years. Males represented 50.2%(n = 16702) of the sample. There were no significant differences between the age and gender of those who were and were not conveyed. Of the total, 4.48%(n = 1493) were not conveyed to the hospital. Of the non-conveyed calls, 73.34%(n = 1081) were assigned a priority level 1 at dispatch and the remainder were priority 2. The majority, 45.16% (n = 504), of cases had a final triage code of yellow, followed by 31% (n = 356) coded green. Following multivariate regression, the following variables increased the odds of nonconveyance: Green triage (OR 2.04; 95% CI 1.77-2.36; p<0.01), weekends (OR 1.27; 95% CI 1.12-1.44; p<0.01), and nebulisation on scene (OR 1.47; 95% CI 1.23-1.74; p<0.01). Conversely, dispatch priority 2 (less urgent; OR 0.66; 95% CI 0.57-0.76; p<0.01), orange triage (OR 0.68; 95% CI 0.58-0.80; p<0.01), red triage (OR 0.22; 95% CI 0.13-0.37; p<0.01), and oxygen administration (OR 0.52, 95% CI 0.41-0.67; p<0.01) were all associated with decreased odds of non-conveyance. Conclusion: Several variables are associated with the non-conveyance of respiratory complaint patients seen to by PGWC EMS. Future research focusing on the predictors for ambulance non-conveyance could lead to raised efficiency and minimisation in operational expenses, and provider fatigue amongst others. 2024-03-05T10:15:47Z 2024-03-05T10:15:47Z 2023 2024-03-05T08:57:02Z Thesis / Dissertation Masters MPhil http://hdl.handle.net/11427/39189 eng application/pdf Division of General Surgery Faculty of Health Sciences |
| spellingShingle | Emergency Medicine Alsufayan, Mohammed Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review |
| thesis_degree_str | Master's |
| title | Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review |
| title_full | Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review |
| title_fullStr | Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review |
| title_full_unstemmed | Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review |
| title_short | Determining the variables associated with EMS non-conveyance of patients with respiratory complaints in Western Cape, South Africa: A retrospective chart review |
| title_sort | determining the variables associated with ems non conveyance of patients with respiratory complaints in western cape south africa a retrospective chart review |
| topic | Emergency Medicine |
| url | http://hdl.handle.net/11427/39189 |
| work_keys_str_mv | AT alsufayanmohammed determiningthevariablesassociatedwithemsnonconveyanceofpatientswithrespiratorycomplaintsinwesterncapesouthafricaaretrospectivechartreview |