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09.02.2021 | Originalien Open Access

Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?

Emergency medical service patients’ survey linked to health claims data

Notfall + Rettungsmedizin
Silke Piedmont, Anna Katharina Reinhold, Dr. Jens-Oliver Bock, PD Enno Swart, Prof. Bernt-Peter Robra
Wichtige Hinweise

Supplementary Information

The online version of this article (https://​doi.​org/​10.​1007/​s10049-020-00832-2) contains further tables. Article and additional material are available at www.​springermedizin.​de. Please enter the title of the article in the search field. You will find the additional material under “Supplementary Material” in the article.
The original online version of this article was revised:
The authors point out that in the methods section of the original article, the following sentence has been corrected. Please note the correct sentence:
We conducted descriptive and in-ferential analysis with IBM®SPSS®Statis-tics Version 25 (IBM Corporation, Ar-monk, NY, USA) and Microsoft Excel2016 using pairwise deletion.
An erratum to this article is available online at https://​doi.​org/​10.​1007/​s10049-021-00918-5.



In many countries, the use of emergency medical services (EMS) increases steadily each year. At the same time, the percentage of life-threatening complaints decreases. To redesign the system, an assessment and consideration of the patients’ perspectives is helpful.


We conducted a paper-based survey of German EMS patients who had at least one case of prehospital emergency care in 2016. Four health insurance companies sent out the questionnaire to 1312 insured persons. We linked the self-reported data of 254 respondents to corresponding claims data provided by their health insurance companies. The analysis focuses a.) how strongly patients tend to call EMS for themselves and others given different health-related scenarios, b.) self-perceived health complaints in their own index case of prehospital emergency care and c.) subjective emergency status in combination with so-called “objective” characteristics of subsequent EMS and inpatient care. We report principal diagnoses of (1) respondents, (2) 57,240 EMS users who are not part of the survey and (3) all 20,063,689 inpatients in German hospitals. Diagnoses for group 1 and 2 only cover the inpatient stay that started on the day of the last EMS use in 2016.


According to the survey, the threshold to call an ambulance is lower for someone else than for oneself. In 89% of all cases during their own EMS use, a third party called the ambulance. The most common, self-reported complaints were pain (38%), problems with heart and circulation (32%), and loss of consciousness (17%). The majority of respondents indicated that their EMS use was due to an emergency (89%). We could detect no or only weak associations between patients’ subjective urgency and different items for objective care.


Dispatchers can possibly optimize or reduce the disposition of EMS staff and vehicles if they spoke directly to the patients more often. Nonetheless, there is need for further research on how strongly the patients’ perceived urgency may affect the disposition, rapidness of the service and transport targets.
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