Abstract
Background
Barriers to EMS care can result in suboptimal outcomes and preventable morbidity and
mortality. Large EMS databases such as the National Emergency Medical Services Information
System (NEMSIS) dataset provide valuable data on the relative incidence of such barriers
to care.
Methods
A retrospective cross-sectional analysis was performed using the NEMSIS database.
Cases of violent trauma were collected based on gender and racial group. Each group
was analyzed for the ratio of cases that involved an EMS barrier to care. Chi-square
testing was used to assess associations, and the relative risk was used as the measure
of strength of association. For all tests, statistical significance was set at the
0.05 level.
Results
719,812 cases of violent trauma were analyzed using the NEMSIS dataset. EMS encountered
barriers to care for white and non-white patients was found to be 4.9% and 4.0% respectively.
The difference between groups was found to be 0.9% (95% CI [0.7%, 1.1%] p < 0.0001). RR was 1.23 for white patients (95% CI [1.19, 1.26]), and 0.82 (95% CI
[0.79, 0.84]) for non-white. EMS barriers to care for male and female patients was
found to be 6.03% and 3.34%, respectively. The difference between groups was found
to be 2.7% (95% CI [2.6%, 2.8%] p < 0.0001). RR for male patients was 1.80 (95% Cl [1.76, 1.84]) while RR for female
patients was 0.55 (95% CI [0.54, 0.57]).
Conclusions
Racially white patients and male patients have a statistically significant higher
risk of encountering an EMS barrier to care in cases of violent trauma.
Abbreviations:
EMS (emergency medical services), NEMSIS (National Emergency Medical Services Information System), NHTSA (National Highway Traffic Safety Administration)Keywords
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Article Info
Publication History
Published online: April 23, 2018
Accepted:
April 22,
2018
Received in revised form:
April 19,
2018
Received:
February 22,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
