Are organized outhospital emergency medical services a solution to overcrowding of Emergency Departments?

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


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.


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.


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%).


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.