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999 EMS Research Forum 2023 meeting abstracts
Poster Presentations
PP62 Predictors of conveyance to hospital by ambulance services of care home patients
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  1. Vanessa Botan1,2,
  2. Graham Law1,
  3. Despina Laparidou1,
  4. Viet-Hai Phung1,
  5. Ffion Curtis3,
  6. Gregory Whitley1,
  7. Joseph Akanuwe1,
  8. Elise Rowan1,
  9. Rachael Fothergill4,
  10. Tracy McCranor4,
  11. Susan Bowler1,
  12. Maria Kordowicz5,
  13. Nicoya Palastanga6,
  14. Lissie Wilkins6,
  15. Robert Spaight7,
  16. Elizabeth Miller7,
  17. Adam Gordon5,
  18. Aloysius Niroshan Siriwardena1
  1. 1University of Lincoln, UK
  2. 2Nottingham Trent University, UK
  3. 3University of Liverpool, UK
  4. 4Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK
  5. 5University of Nottingham, UK
  6. 6Healthier Aging Patient and Public Involvement Group, University of Lincoln, UK
  7. 7East Midlands Ambulance Service NHS Trust, Lincoln, UK

Abstract

Background Residents of care homes may be affected by medical emergencies, resulting in ambulance attendance and conveyance to hospital which add extra pressure and costs on an already strained emergency and healthcare system. The aim of this study was to determine the factors predicting conveyance to hospital of care home residents by ambulance services.

Methods We used a cross-sectional study design analysing routine data from electronic clinical records from East Midlands Ambulance Service NHS Trust (EMAS) from 2018 to 2021. A multivariable multinominal regression model was used to identify the main predictors of conveyance to hospital or referral to community services.

Results The data included 170,612 attendances to care homes representing 7.5% of the total number of EMAS attendances between 2018-2021. The main predictors of conveyance to hospital were being male (Relative Risk Ratio [RRR] 1.07, 95% Confidence Interval [CI] 1.03-1.10, p<0.001), aged 70-79 years (RRR 1.09, 95%CI 1.03-1.17, p<0.001) or 80-89 years (RRR 1.10, 95%CI 1.03-1.17, p<0.001), situated in an area of higher deprivation (RRR 1.06, 95%CI 1.03-1.09, p<0.001), or having dispatch categories which included cardiovascular (RRR 11.29, 95%CI 10.43-12.22, p<0,001), trauma including falls (RRR 9.50, 95%CI 8.97-10.05, p<0,001) or neurological (RRR 9.06, 95%CI 8.42-9.75, p<0,001) conditions. Calls made by health care professionals (HCPs) (RRR 15.37, 95%CI 13.41-17.62, p<0,001) or where patients had a higher National Early Warning Score (NEWS2) (RRR 1.23, 95%CI 1.22-1.24, p<0,001) resulted in significantly increased conveyance.

Conclusion A series of factors significantly predict conveyance to hospital by ambulance of home care residents. These include HCP referral or NEWS2 confirming that the severity of clinical condition of the patient was associated with significantly increased conveyance. Future interventions to prevent or address certain conditions such as falls or provide enhanced care in care homes may prevent some emergencies or reduce the risk of conveyance to hospital.

https://doi.org/10.1136/emermed-2023-999.61

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