Factors Influencing EMS Utilization in Patients With STEMI

HealthDay News — Patients with ST-elevation myocardial infarction (STEMI) perceptions, including those involving the speed of transport and concerns about resource misuse, are an important factor in determining emergency medical services (EMS) use, according to a study published in the Journal of Evaluation in Clinical Practice.

Matthew Mercuri, PhD, from McMaster University in Hamilton, Canada, and colleagues conducted semi-structured interviews with 61 patients with STEMI admitted to a large tertiary care center. Patients were classified according to mode of transport to the hospital at the time of the index event (32 EMS, 29 self-transport).

The researchers found that the likelihood of having a Killip Class > 1 was higher for EMS users (25% vs 4%).

Compared with EMS patients, self-transport patients were more likely to perceive EMS as slower (48% vs 0%) and express concerns over resources misuse (34% vs 3%). The likelihood of acknowledging the benefits of EMS was higher for patients who accessed EMS (44% vs 7%); they were also more likely to have been encouraged by a family member to call EMS (34% vs 4%).

“Patients with STEMI perceptions are a key factor in determining EMS use,” the authors write. “Health care stakeholders should target the identified barriers to improve utilization of EMS, and develop strategies to optimize care for patients who do not access EMS.”

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Mercuri M, Connolly K, Natarajan MK, et al. Barriers to the use of emergency medical services for ST-elevation myocardial infarction: determining why many patients opt for self-transport [published online December 13, 2017.] J Eval Clin Pract. doi: 10.1111/jep.12858.