[Emergency ambulance call-outs often provide primary care].

Objective: To examine patient and care characteristics of emergency ambulance call-outs and to determine how many of them were, in retrospect, effectively providing primary care.

Design: Retrospective cross-sectional study.

Method: We charted patient and care characteristics of 598 emergency ambulance call-outs in the Zuid-Gelderland region in the east of the Netherlands by applying a retrospective dossier analysis method. Three reviewers independently retrospectively determined what the required care was: primary or secondary care. This judgment was compared with the actual care given to the patient: treatment-on-the-spot or transfer to hospital.

Results: A1 care was provided in 74.1% and A2 care in 25.9% of the ambulance call-outs. Mean patient age was 49.2 years and 53.3% of the patients were male. The probability diagnoses 'becoming unwell' (11.5%) and 'trauma to extremity' (11.2%) were the most common. In retrospect, the patient could have been treated in primary care, or self-treated, in 42.3% of the ambulance call-outs. The percentage of primary care was higher during office hours than out of hours (49 vs 39). In 91.7% of cases the required care as determined by the reviewers was the same as the actual follow-up care given to the patient by paramedics.

Conclusion: Almost half of emergency ambulance call-outs effectively provide primary care. This finding reinforces the need for research into cooperation between ambulance services, primary care practices and out-of-hours primary care cooperatives.