title: A high proportion of prehospital emergency patients are not transported by ambulance: a retrospective cohort study in Northern Finland.
abstract: BACKGROUND
  The number of missions in the emergency medical services (EMS) has increased considerably in recent years. People are requesting ambulance for even minor illnesses and non-medical problems, which is placing financial and resource burdens on the EMS. The aim of this study was to determine the rate of non-transportation missions in Northern Finland and the reasons for these missions.
  
  
  METHODS
  All ambulance missions in two hospital districts in Northern Finland during the 6-month period of January 1 through June 30, 2014, were retrospectively evaluated from the EMS charts to identify missions in which the patients were not transported by the EMS. The non-transportation rates and reasons were calculated and expressed as percentages.
  
  
  RESULTS
  In 41.7% of the 13,354 missions, the patient was not transported from the scene by an ambulance. After a medical assessment and care was provided by the EMS, 48.2% of these non-transport patients were evaluated as not needing further treatment in the emergency department and were directed to contact the municipal health care center during office hours. There was no need for any medical care in 39.9% of non-transportation missions.
  
  
  CONCLUSIONS
  This study showed a high rate of EMS missions resulting in non-transportation in two hospital districts in Northern Finland. In the majority of these missions there was no need for emergency admission to an emergency department or for any medical care at all. These findings indicate that an improvement in the dispatch process and primary care resources might be of benefit.
authors.affiliation: Medical Research Center, Research Group of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland.|Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Hoikka
authors.affiliation: Emergency Medical Service, Department of Emergency Medicine, Helsinki University Central Hospital and University of Helsinki, Oulu, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Silfvast
authors.affiliation: Medical Research Center, Research Group of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland.|Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
authors.forename: T I
authors.initials: TI
authors.lastname: Ala-Kokko
mesh_terms: D000368:Aged; D000552:Ambulances / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000379:methods* / Q000706:statistics & numerical data*