Epidemiology of prehospital emergency calls according to patient transport decision in a middle eastern emergency care environment: Retrospective cohort-based

Hassan Farhat; Guillaume Alinier; Kawther El Aifa; Ahmed Makhlouf; Padarath Gangaram; Ian Howland; Andre Jones; Cyrine Abid; Mohamed Chaker Khenissi; Ian Howard; Moncef Khadhraoui; Nicholas Castle; Loua Al Shaikh; James Laughton; Imed Gargouri

doi:10.1002/hsr2.2056

Epidemiology of prehospital emergency calls according to patient transport decision in a middle eastern emergency care environment: Retrospective cohort-based

Health Sci Rep. 2024 Apr 23;7(4):e2056. doi: 10.1002/hsr2.2056. eCollection 2024 Apr.

Authors

Hassan Farhat^{1

2

3}, Guillaume Alinier^{1

4

5

6}, Kawther El Aifa¹, Ahmed Makhlouf^{1

7}, Padarath Gangaram^{1

8}, Ian Howland¹, Andre Jones¹, Cyrine Abid⁹, Mohamed Chaker Khenissi¹, Ian Howard¹, Moncef Khadhraoui¹⁰, Nicholas Castle¹, Loua Al Shaikh¹, James Laughton¹, Imed Gargouri¹¹

Affiliations

¹ Ambulance Service Hamad Medical Corporation Doha Qatar.
² Faculty of Sciences University of Sfax Sfax Tunisia.
³ Faculty of Medicine 'Ibn El Jazzar' University of Sousse Sousse Tunisia.
⁴ University of Hertfordshire Hatfield UK.
⁵ Weill Cornell Medicine-Qatar Doha Qatar.
⁶ Northumbria University Newcastle upon Tyne UK.
⁷ College of Engineering Qatar University Doha Qatar.
⁸ Faculty of Health Sciences Durban University of Technology Durban South Africa.
⁹ Laboratory of Screening Cellular and Molecular Process, Centre of Biotechnology of Sfax University of Sfax Sfax Tunisia.
¹⁰ Higher Institute of Biotechnology University of Sfax Sfax Tunisia.
¹¹ Faculty of Medicine University of Sfax Sfax Tunisia.

Abstract

Background and aim: Though emergency medical services (EMS) respond to all types of emergency calls, they do not always result in the patient being transported to the hospital. This study aimed to explore the determinants influencing emergency call-response-based conveyance decisions in a Middle Eastern ambulance service.

Methods: This retrospective quantitative analysis of 93,712 emergency calls to the Hamad Medical Corporation Ambulance Service (HMCAS) between January 1 and May 31, 2023, obtained from the HMCAS electronic system, was analyzed to determine pertinent variables. Sociodemographic, emergency dispatch-related, clinical, and miscellaneous predictors were analyzed. Descriptive, bivariate, ridge logistic regression, and combination analyses were evaluated.

Results: 23.95% (N = 21,194) and 76.05% (N = 67,285) resulted in patient nontransport and transportation, respectively. Sociodemographic analysis revealed that males predominantly activated EMS resources, and 60% of males (n = 12,687) were not transported, whilst 65% of females (n = 44,053) were transported. South Asians represented a significant proportion of the transported patients (36%, n = 24,007). "Home" emerged as the primary emergency location (56%, n = 37,725). Bivariate analysis revealed significant associations across several variables, though multicollinearity was identified as a challenge. Ridge regression analysis underscored the role of certain predictors, such as missing provisional diagnoses, in transportation decisions. The upset plot shows that hypertension and diabetes mellitus were the most common combinations in both groups.

Conclusions: This study highlights the nuanced complexities governing conveyance decisions. By unveiling patterns such as male predominance, which reflects Qatar's expatriate population, and specific temporal EMS activity peaks, this study accentuates the importance of holistic patient assessment that transcends medical histories.

Keywords: Middle East; cohort study; emergency medical service; patient decisions; prehospital care.