The Need for Emergency Case Management in Family Medicine: A Capital City Case

INTRODUCTION: The aim of this study is to evaluate 112 emergency ambulance calls made from primary healthcare institutions and to determine the reasons for patient referrals,the most frequent (pre)diagnoses they received according to age groups, and the frequency of encounters with these patients.Additionally, the study aims to identify which topics should carry more weight in family medicine specialty education and in-service training for individuals working in family health centers.
METHODS: Our study is a retrospective cross-sectional and descriptive study. Between November 2018 and November 2019, we retrospectively reviewed 112 emergency ambulance requests from family health centers in Ankara using the 112 command and control center archive records of the relevant patients. A total of 1829 calls were evaluated. Various parameters such as age, gender, vital signs, urban/rural case status, reason for the call, type of call termination, the ICD-10 diagnostic code, and ambulance type were analyzed.
RESULTS: Among the patients, 45.54% were female. The mean patient age was 47.31±24.62 years. The most frequent triage code assigned to patients was code yellow, accounting for 46.36% of cases. While 33.95% of patients were referred due to cardiovascular diseases, 12.52% for trauma, 7.22% for gastrointestinal diseases, and 6.62% for pulmonary diseases. Trauma and fever were more prominent in pediatric cases. Among diagnoses in the geriatric age group, vertigo was identified as one of the top five diagnoses.
DISCUSSION AND CONCLUSION: Medical reasons constituted the most common causes for 112 emergency ambulance requests, and the primary method of resolution by 112 teams was hospital transfer. Through this study, we identified the primary care physician's most frequent involvement in emergency case management and areas where they require assistance. A majority of the relevant cases were assigned code yellow, indicating that reinforcing family health centers could provide a solution to alleviate unnecessary patient overcrowding in emergency departments.