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

Hassan N. Moafa, Sander M. J. van Kuijk, Mohammed E. Moukhyer, Dhafer M. Alqahtani and Harm R. Haak
Additional contact information
Hassan N. Moafa: Department of Health Services Management, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan 82817 2820, Saudi Arabia
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

IJERPH, 2021, vol. 18, issue 17, 1-13

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.

Keywords: emergency medical services; non-conveyance; patient-initiated refusal; emergencies; Riyadh; Saudi Arabia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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