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Use of prehospital emergency medical services according to income of residential area
  1. Mia Aitavaara-Anttila1,
  2. Janne Liisanantti1,2,
  3. Ari Ehrola3,
  4. Michael Spalding1,2,
  5. Tero Ala-Kokko4,5,
  6. Lasse Raatiniemi1,6
  1. 1 Research group of anesthesiology, Medical Research Centre, University of Oulu, Oulu, Finland
  2. 2 Department of anesthesiology, Oulu University Hospital, Oulu, Finland
  3. 3 Emergency Medical Services, Oulu-Koillismaa Rescue Department, Oulu University Hospital, Oulu, Finland
  4. 4 Department of intensive care, Oulu University Hospital, Oulu, Finland
  5. 5 Research group of intesive care, Medical research center, University of Oulu, Oulu, Finland
  6. 6 Centre for Pre-Hospital Emergency Care, Oulu University Hospital, Oulu, Finland
  1. Correspondence to Dr Mia Aitavaara-Anttila, Anesthesiology Surgery and Intensive Care, Oulu University Hospital, Oulu 90220, Finland; mia.aitavaara{at}


Background The increasing usage of emergency medical services (EMS) missions is a challenge in modern practice. This study was designed to examine the association of the income level of residential areas on the rate of EMS missions and the frequency of EMS use in these areas.

Methods All EMS missions for adult patients (>18 years) encountered by one rescue department in Northern Finland between June 2015 and May 2017 were analysed. The area served was categorised into four categories, according to the median annual income of the postal code areas. EMS missions per 1000 person-years, rate of non-transport missions and the number of dispatches to frequent (>4 EMS calls/year and highly frequent (>10 calls/year)EMS users per area were investigated.

Results There were 62 759 EMS missions, 34.8% of which resulted in non-transport. The crude rate of EMS dispatches was higher in the low-income area compared with other income areas (133.3 vs 108.9 vs 111.3 vs 73.6/1000 person-years) as well as the rate of high-frequency user dispatches (21.5 vs 11.5 vs 7.2 vs 4.3/1000-person years). The rate of non-transports missions was higher also (69.4 vs 43.4 vs 42.5. vs 30.6/1000 person-years). The highest crude rate of EMS use was found in people older than 65 years living in the lowest income areas (294.8/1000 person-years). After age adjustment, the highest rate of EMS use was found in rural areas with the lowest income (146.3/1000 person-years).

Conclusions The rate of the EMS missions and non-transport missions differs significantly among different income areas. Resource usage was significantly higher in the low income areas. This information can be used in planning allocation of EMS and preventive healthcare resources.

  • pre-hospital care
  • basic ambulance care
  • emergency ambulance systems

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  • Contributors LR and JL conceived and designed the study. AE collected and JL analysed the data. The manuscript was prepared by all of the authors after interpreting the results. MA-A submitted the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. According to Finnish law, we can not share data outside of Finland.