Emergency medical services
Outhospital emergency medicine experience of SOS Doctors, Athens, Greece
George Theocharis, Theodore Spiropoulos, Spyridon Barbas, Ioannis Salpigktis, George Peppas
SOS Doctors, Athens, Greece
Background:
Overcrowding in ED is a major medical issue because of its multiple negative effects. Organized outhospital emergency medical services can be a solution to ED overcrowding. SOS Doctors, Athens, is a network of specialized physicians who perform emergency house calls on a 24hr basis.
Object: To present a model of outhospital emergency medicine according to SOS Doctors and its impact in avoiding admission to ED.
Material:
We analyzed retrospectively for the years 2009-2011 the data of 101.596 cases dealt by SOS Doctors, concerning the patients’ sex and age, the principal complaints, the final diagnoses and the rate of hospital admission.
Results:
From the total of 101.596 house calls performed during the evaluated period females requested more house calls compared to males (56.6% versus 43.4%). Patients older than 65 years requested 59.9% of house calls followed by patients aged between 15-44 (18.2%).
The more frequent complaints were: fever 14517(14.3%), diarrheas/vomiting 6578(6.5 %), abdominal pain 4791(4.7 %), cough 4372 (4.3%), dizziness 3442(3.4%).
The more frequent diagnoses were: respiratory infections 13169(12.9%), gastroenteritis 5468(5.4%), hypertension 3210(3.2%), vertigo 3033(3%).
Emergency hospital admission was necessary for 5.212 patients (5.1%).
Discussion:
The main finding of our study is that house calls provided by organized outhospital emergency systems can be a solution of overcrowding of ED. Most of our patients were older than 65 years and admission rate was only 5.1%. Comparing our findings with those of the National Hospital Ambulatory Medical Care Survey (USA) we note that 15.5% of the patients visited ED in USA were older than 65 years and the general admission rate was 15%.
Conclusion: According to SOS Doctors’ experience, house calls performed by specialized doctors on a 24hr basis can be an effective form of emergency medical care, especially for the elderly and may reduce overcrowding of Hospital ED.