title: Increasing prehospital emergency medical service interventions for nursing home residents.
abstract: OBJECTIVE
  In the ageing European population, the proportion of interventions by the emergency medical services (EMS) for elderly patients is increasing, but little is known about the recent trend of EMS interventions in nursing homes. The aim of this analysis was to describe the evolution of the incidence of requests for prehospital EMS interventions for nursing home residents aged 65 years and over between 2004 and 2013.
  
  
  METHODS
  A prospective population-based register of routinely collected data for each EMS intervention in the Canton of Vaud. Linear time trends of incidence of requests to the EMS in nursing homes were calculated and stratified by age categories.
  
  
  RESULTS
  The number of ambulance interventions in nursing homes for people aged 65 years and over (65+) increased by 68.9% (1124‒1898) between 2004 and 2013. A significant linear increase of the annual incidence of requests to EMS per 1,000 nursing home residents was found for people aged 65-79 (10.2, 95% confidence interval [CI] 6.2-14.2), 80-89 (16.5, 95% CI 14.0-19.0) and over 90 (12.1, 95% CI 5.8-18.4). EMS interventions in nursing home residents who required an emergency physician increased during the same period by 205.6% (from 106 to 324), representing an increase from 2% to 7% of all emergency physician interventions in the Canton.
  
  
  CONCLUSIONS
  Our results confirmed an important increase in the incidence of EMS interventions in nursing homes during the last decade, far exceeding the actual increase of the nursing home population during the same period. This evolution represents an important opportunity to reconsider the EMS missions in the context of an ageing society.
authors: Emergency Department, Lausanne University Hospital, Switzerland.
authors: Pierre-Nicolas
authors: PN
authors: Carron
authors: Emergency Department, Lausanne University Hospital, Switzerland; Emergency Medical Services, Dispatch Centre, State of Vaud (Fondation Urgences Santé - 144), Lausanne, Switzerland.
authors: Fabrice
authors: F
authors: Dami
authors: Emergency Department, Lausanne University Hospital, Switzerland.
authors: Bertrand
authors: B
authors: Yersin
authors: Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
authors: Valérie
authors: V
authors: Toppet
authors: Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
authors: Bernard
authors: B
authors: Burnand
authors: Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
authors: Valérie
authors: V
authors: Pittet
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000706:statistics & numerical data / Q000639:trends*; D004635:Emergency Medicine / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D013557:Switzerland