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Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia

Author

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  • Hassan N. Moafa

    (Department of Health Services Management, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan 82817 2820, Saudi Arabia
    Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, 6229 GT Maastricht, The Netherlands
    Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands)

  • Sander M. J. van Kuijk

    (Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands)

  • Mohammed E. Moukhyer

    (Department of Academic Development and Quality, Faculty of Applied Medical Sciences, Jazan University, Jazan 82511, Saudi Arabia)

  • Dhafer M. Alqahtani

    (Department of Electronic Transaction Management, Saudi Red Crescent Authority, Ministry of Health, Riyadh 13251-8261, Saudi Arabia)

  • Harm R. Haak

    (Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, 6229 GT Maastricht, The Netherlands
    Department of Internal Medicine, Maxima Medisch Centre, 5631 BM Eindhoven, The Netherlands
    Department of Internal Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands)

Abstract

This research study aimed to investigate the association between demographic and operational factors and emergency medical services (EMS) missions ending in non-conveyance (NC) due to patient-initiated refusal (PIR). We conducted a retrospective population-based registry study by analyzing 67,620 EMS missions dispatched to the scene during 2018 in the Riyadh province. First, the number and percentages of conveyances statuses were calculated. Then, using crude and adjusted linear and logistic regression analysis, we determined which characteristics were predictors of NC due to PIR. We found that 23,991 (34.4%) of missions ended in NC due to PIR, and 5969 ended in EMS-initiated refusal (8.6%). NC rates due to PIR were higher for women, adults, for missions in Riyadh city, during nighttime, for medical emergencies, and for advanced life support (ALS) crews. We also found the following additional predictors significantly associated with the odds of NC due to PIR in crude regression analyses: age category, geographical location, EMS-shift, time of call, emergency type, and response time. We conclude that the NC rate represents half of all missions for patients requesting EMS, and the rate in Riyadh city has increased compared to previous studies. Most NC cases occur for the highest urgency level of medical emergency type in Riyadh city during the nighttime with ALS crews. NC due to PIR involves younger patients more than elderly, and females more than males. This study’s findings have provided empirical evidence that indicate that conducting further studies involving EMS providers, patients, and the public to identify precise and detailed reasons is required.

Suggested Citation

  • Hassan N. Moafa & Sander M. J. van Kuijk & Mohammed E. Moukhyer & Dhafer M. Alqahtani & Harm R. Haak, 2021. "Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia," IJERPH, MDPI, vol. 18(17), pages 1-13, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:9252-:d:627506
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    References listed on IDEAS

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    1. Sundus Dawoud & Alaeddin Mohammad K. Ahmad & Omar Z. Alsharqi & Rajaa M. Al-Raddadi, 2016. "Utilization of the Emergency Department and Predicting Factors Associated With Its Use at the Saudi Ministry of Health General Hospitals," Global Journal of Health Science, Canadian Center of Science and Education, vol. 8(1), pages 1-90, January.
    2. Hassan N. Moafa & Sander Martijn Job van Kuijk & Dhafer M. Alqahtani & Mohammed E. Moukhyer & Harm R. Haak, 2020. "Disparities between Rural and Urban Areas of the Central Region of Saudi Arabia in the Utilization and Time-Centeredness of Emergency Medical Services," IJERPH, MDPI, vol. 17(21), pages 1-14, October.
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    Cited by:

    1. Hassan Farhat & Cyrine Abid & Kawther El Aifa & Padarath Gangaram & Andre Jones & Mohamed Chaker Khenissi & Moncef Khadhraoui & Imed Gargouri & Loua Al-Shaikh & James Laughton & Guillaume Alinier, 2023. "Epidemiological Determinants of Patient Non-Conveyance to the Hospital in an Emergency Medical Service Environment," IJERPH, MDPI, vol. 20(14), pages 1-20, July.

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