OBJECTIVE: To determine the rate of subsequent emergency department (ED) care, inpatient stay or death of injured emergency medical service (EMS) patients who refuse treatment or hospital transport and to examine the demographics for these patients compared to other injured EMS patients. METHODS: Utah EMS data for 1996 and 1997 were probabilistically linked to statewide ED, inpatient and death certificate data. The EMS data was restricted to patients who had an injury related dispatch code. Community demographic information was obtained by matching the zip code of the location for the EMS run to census data. RESULTS: We studied 37,410 injured EMS patients. The rate of ED care per 100 EMS patients was 16.4 for patients treated and released with medical advice, 16.8 for patients who refused care, and 24.8 for patients treated and released against medical advice. Less then 1 % of these patients had an inpatient or death certificate record. Non-transported patients were more likely to be seen for a motor vehicle crash, assault, stabbing or gunshot wounds than transported patients (p<0.001). Patients who were treated and released against medical advice came on average from ZIP codes with a median income approximately $10,000 less than the other EMS patients. They were also 2 times more likely to be from multi-ethnic neighborhoods than the other EMS patients. CONCLUSIONS: A segment of the injured EMS patient population, especially those in lower income areas are not having their medical needs addressed possible due to their financial or legal concerns.
Learning Objectives: N/A
Keywords: EMS/Trauma, Injury
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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