title: [Emergency ambulance call-outs often provide primary care].
abstract: OBJECTIVE
  To examine patient and care characteristics of emergency ambulance call-outs and to determine how many of them were, in retrospect, effectively providing primary care.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  We charted patient and care characteristics of 598 emergency ambulance call-outs in the Zuid-Gelderland region in the east of the Netherlands by applying a retrospective dossier analysis method. Three reviewers independently retrospectively determined what the required care was: primary or secondary care. This judgment was compared with the actual care given to the patient: treatment-on-the-spot or transfer to hospital.
  
  
  RESULTS
  A1 care was provided in 74.1% and A2 care in 25.9% of the ambulance call-outs. Mean patient age was 49.2 years and 53.3% of the patients were male. The probability diagnoses 'becoming unwell' (11.5%) and 'trauma to extremity' (11.2%) were the most common. In retrospect, the patient could have been treated in primary care, or self-treated, in 42.3% of the ambulance call-outs. The percentage of primary care was higher during office hours than out of hours (49 vs 39). In 91.7% of cases the required care as determined by the reviewers was the same as the actual follow-up care given to the patient by paramedics.
  
  
  CONCLUSIONS
  Almost half of emergency ambulance call-outs effectively provide primary care. This finding reinforces the need for research into cooperation between ambulance services, primary care practices and out-of-hours primary care cooperatives.
authors.affiliation: Radboudumc, afd. Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen.
authors.forename: Marleen
authors.initials: M
authors.lastname: Smits
authors.forename: Oscar
authors.initials: O
authors.lastname: Francissen
authors.forename: Marleen
authors.initials: M
authors.lastname: Weerts
authors.forename: Karlijn
authors.initials: K
authors.lastname: Janssen
authors.forename: Pierre
authors.initials: P
authors.lastname: van Grunsven
authors.forename: Paul
authors.initials: P
authors.lastname: Giesen
mesh_terms: D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004630:Emergencies; D004632:Emergency Medical Services / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011320:Primary Health Care; D012189:Retrospective Studies