TY - JOUR

T1 - Patient characteristics and dispatch responses of urinary tract infections in a prehospital setting in Copenhagen, Denmark

T2 - a retrospective cohort study

AU - Verhoeven, Jeske

AU - Christensen, Helle Collatz

AU - Blomberg, Stig Nikolaj

AU - Böbel, Simone

AU - Scholz, Mirjam

AU - Krafft, Thomas

N1 - Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - Background: Urinary tract infection (UTI) is particularly common in young women and the elderly. The Emergency Medical Services (EMS) in Copenhagen, Denmark can be reached by calling either of two dedicated telephone lines: 1–1-2 in case of an emergency and 1813 during general practitioner’s (GP) out-of-office hours (OOH). This study investigated characteristics of patients with symptoms of UTI calling the Copenhagen EMS and the response they received. Methods: A retrospective observational cohort study was conducted in which 7.5 years of telephone data on UTI from the EMS in Copenhagen were analyzed. Descriptive statistics and multinomial logistic regression were used to analyze patient characteristics, the timing of the incident and response. Patients’ age and gender were assessed and the use of urinary catheters, the timing of the incident, and the impact on the response were evaluated. Results: A total of 278.961 calls were included (78% female, mean age 47), with an average of 120 patients with UTI symptoms calling each day. Most people contacted the 1813-medical helpline (98%) and of those, the majority were referred to the emergency department (ED)(37%). Patients were more likely to be referred to the ED during the weekend compared to a weekday and less likely during OOH compared to in-office hours (IH). Patients with a urinary catheter were more likely to receive specialized care referred to as ‘other’. For the smaller proportion of patients calling 1–1-2, most people got a B (urgent) response (1.5%). The most likely response to be given was an A (emergency) or F (non-emergency) response during OOH compared to IH and on weekends compared to weekdays. Patients with a urinary catheter were more likely to receive a D (unmonitored transport) response. Conclusions: Since 2015, there was a decrease in 1813 antibiotic prescription rates and a subsequent increase in referral to the ED of UTI patients. Patients were referred less to the ED during OOH as they were likely to be sent to their GP the next day. During the weekend, patients were referred more to the ED for the likely reason that their GP is closed.

AB - Background: Urinary tract infection (UTI) is particularly common in young women and the elderly. The Emergency Medical Services (EMS) in Copenhagen, Denmark can be reached by calling either of two dedicated telephone lines: 1–1-2 in case of an emergency and 1813 during general practitioner’s (GP) out-of-office hours (OOH). This study investigated characteristics of patients with symptoms of UTI calling the Copenhagen EMS and the response they received. Methods: A retrospective observational cohort study was conducted in which 7.5 years of telephone data on UTI from the EMS in Copenhagen were analyzed. Descriptive statistics and multinomial logistic regression were used to analyze patient characteristics, the timing of the incident and response. Patients’ age and gender were assessed and the use of urinary catheters, the timing of the incident, and the impact on the response were evaluated. Results: A total of 278.961 calls were included (78% female, mean age 47), with an average of 120 patients with UTI symptoms calling each day. Most people contacted the 1813-medical helpline (98%) and of those, the majority were referred to the emergency department (ED)(37%). Patients were more likely to be referred to the ED during the weekend compared to a weekday and less likely during OOH compared to in-office hours (IH). Patients with a urinary catheter were more likely to receive specialized care referred to as ‘other’. For the smaller proportion of patients calling 1–1-2, most people got a B (urgent) response (1.5%). The most likely response to be given was an A (emergency) or F (non-emergency) response during OOH compared to IH and on weekends compared to weekdays. Patients with a urinary catheter were more likely to receive a D (unmonitored transport) response. Conclusions: Since 2015, there was a decrease in 1813 antibiotic prescription rates and a subsequent increase in referral to the ED of UTI patients. Patients were referred less to the ED during OOH as they were likely to be sent to their GP the next day. During the weekend, patients were referred more to the ED for the likely reason that their GP is closed.

KW - Cystitis

KW - Dispatch response

KW - Emergency medical dispatch

KW - Emergency medical services

KW - Emergency response

KW - Out-of-hours primary care

KW - Urinary tract infection

U2 - 10.1186/s12875-022-01915-4

DO - 10.1186/s12875-022-01915-4

M3 - Journal article

C2 - 36496366

AN - SCOPUS:85143694176

VL - 23

JO - BMC Primary Care

JF - BMC Primary Care

SN - 2731-4553

M1 - 319

ER -