Evaluation of Compliance of Patients Admitted to Emergency Department By 112 Ambulances According to International 32 Emergency Parameters

Research Article





Ambulance, Emergency Department, Urgency, 112


Introduction: The inappropriate use of ambulances increases the workload of emergency services and adversely affects the economy.

Objective: We aimed to compare the compliance of the prediagnosis and the final diagnosis of cases brought to the emergency department by 112 ambulances with the World Health Organization (WHO) International 32 Emergency Parameter and investigate their possible inappropriate usage status.

Method: The compliance status of the prediagnosis and final diagnosis of the patients with the WHO International 32 Emergency Parameters were compared (n: 7521). Statistical analysis was conducted using MedCalc® Software and a value of 95% was used for confidence interval. This study is based on a specialization thesis.

Results: While the most frequent diagnosis group among the prediagnostically compliant ones was trauma (26.3%), the most frequent diagnosis group among the final diagnostically compliant ones was cardiovascular system diseases (20.1%). A significant difference was observed when comparing the compliance status with the indicators (McNemar Test, p<0.05).

Conclusion: In our study, in cases brought to the emergency department by 112 ambulances, the rate discrepancy of their final diagnoses was found to be higher compared to the prediagnosis group. This fact shows that even the cases that showed no compliance with the international parameters were referred to emergency departments via ambulance.


Morgans A, Burgess S. Judging a patient’s decision to seek emergency healthcare: clues for managing increasing patient demand. Aust Health Rev. 2012 ;36:110-4.

Yaylacı S ve ark. Ambulans Başvurularında Aciliyetin Değerlendirilmesi ACU Sağlık Bil 2013(4):64-7.

Shiber JR, Longley MB, Brewer KL. Hyper-use of the ED. Am J Emerg Med. 2009;27:588-94.

Moskop JC, Sklar DP, Geiderman JM, Schears RM, Bookman KJ. Emergency department crowding, part 1concept, causes, and moral consequences. Ann Emerg Med. 2009;53:605-11.

Pines JM, Prabhu A, McCusker CM, Hollander JE. The effect of ED crowding on education. Am J Emerg Med. 2010;28(2):217-20.

Dale J, Williams S, Foster T, Higgins J, Snooks H, Crouch R, Hartley-Sharpe C, Glucksman E, George S. Safety of telephone consultation for non-serious emergency ambulance service patients. Qual Saf Health Care. 2004;13:363373.

Gibson G. Measures of emergency ambulance effectiveness: unmet need and inappropriate use. J Am Coll Emergy Phys. 1977;6:38992.

Brown E, Sindelar J. The emergent problem of ambulance misuse. Ann Emerg Med. 1993;22:646-50.

Morris DL, Cross AB. Is the emergency service abused? BMJ. 1980; 281:121-23.

Gardner G J. The use and abuse of the emergency ambulance service: some of the factors affecting the decision to call an emergency ambulance. Arch Emerg Med. 1990;7:81-9.

Palazzo F F, Warner O J, Harron M, Sadana A. Misuse of the London Ambulance Service: how much and why? J Accid Emerg Med. 1998;15:368-70.

Brim C. A descriptive analysis of the non-urgent use of emergency departments. Journal of Nursing Research 2008;15(3):72-88.

Hoot NR, Aronsky D. Systematic review of emergency department crowding: causes, effects, and solutions annals of emergency medicine 2008;52(2):126-36.

Durand AC, Palazzolo S, Tanti-Hardouin N, Gerbeaux P, Sambuc R, Gentile S. Nonurgent patients in emergency departments: rational or irresponsible consumers? Perceptions of professionals and patients. BMC Research Notes 2012;5:525-33.

Snooks H, Wrigley H, George S, Thomas E, Smith H, Glasper A. Appropriateness of use of emergency ambulances. J Accid Emerg Med 1998; 15: 212-5.

McConnel CE, Wilson RW. The demand for prehospital emergency services in an aging society. Soc Sci Med. 1998: 46;1027-31.

Kurtoğlu G, Karakayalı O, Temrel T.A, Arık Y.E, İçme F, Sener A. 112 ile acil servise getirilen vakaların değerlendirilmesi. Turkish Medical Journal 2012:6(3): 73-6.

Chan TC, Killeen JP, Kelly D, Guss DA. Impact of rapid entry and accelerated care at triage on reducing emergencydepartment patient wait times, lengths of stay, and rate of left without being seen. Ann Emerg Med. 2005 Dec; 46(6):491-7.

Kennedy J, Rhodes K, Walls CA, et al. Access to emergency care: restricted by long waiting times and cost and coverage concerns. Ann Emerg Med. 2004; 43:567-73.

Goodacre S, Webster A. Who waits longest in the emergency department and who leaves without being seen? Emerg Med J. 2005 Feb; 22(2):93-6.

Arendt HW, Sadosty AT, Weaver AL, et al. The left without being seen patients: what would keep them from leaving? Ann Emerg Med. 2003; 42:317-23.




How to Cite

Yıldız, Y., & Kayacı Yıldız, M. (2024). Evaluation of Compliance of Patients Admitted to Emergency Department By 112 Ambulances According to International 32 Emergency Parameters: Research Article. Acta Medica Ruha, 2(1), 14–19. https://doi.org/10.5281/zenodo.10687657



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