J Korean Soc Emerg Med.  2021 Oct;32(5):422-431.

Analysis of pre-hospital emergency medical services use feasibility with emergency department visit patient

• Kim HJ
• Kim JY
• Yoon YH
• Park S
• Lee ES

Abstract

Objective
Patients are taken to the emergency department (ED) via a variety of transport systems. Proper ambulance use is important for improving patients’ transport quality and using limited resources allotted by the system effectively. Korea is a country with a well-developed public ambulance system established by the government. Therefore, this study was conducted to analyze the overuse or underuse of the ambulance system by patients who visited the ED.
Methods
This study was conducted at the ED in three hospitals. A total of 459,647 patients visited these EDs over the three-year study period from 2016 to 2018. Medical records were investigated retrospectively. The study subjects were divided into three groups based on their triage score and ambulance use. Patients were classified into adequacy (Korean Triage and Acuity Scale [KTAS] 1-3, ambulance use or KTAS 4-5, non-ambulance use), underuse (KTAS 1-3, non-ambulance use) and overuse (KTAS 4-5, ambulance use) groups.
Results
The mean age of patients was 46.7±26.0 years, and 237,118 (51.6%) were male. The adequacy group included 269,046 patients (58.5% of the patients). The underuse group had 162,575 patients (35.4%), and the overuse group included 328,026 patients (6.1%). Despite having KTAS level 1 or 2, the number of patients who did not use an ambulance was 14,792. Ambulances were used by 5,154 patients at KTAS 5 level.
Conclusion
Many patients use ambulances appropriately, but overuse and underuse of ambulances can still be observed. Guidelines on ambulance use are necessary for the efficient use of emergency medical resources and the safety of patients.

Keyword

Emergency medical services; Ambulances; Triage