Evaluating call prioritisation discrepancies and Emergency Medical Services resource allocation in the North West province of South Africa

Abstract

Abstract: The overwhelming flow of non-emergent cases burdens Emergency Medical Services (EMS), reducing their capacity to respond to life-threatening emergencies and compromising care for patients with emergent clinical needs. This study evaluated the appropriateness of the EMS deployment in a district of the North West Province in South Africa. Methods: A retrospective quantitative descriptive analysis was conducted on cases completed by the district EMS service between 1 and 12 January 2022. Patient report forms and control room assessment forms, containing demographic and clinical data, were analysed to assess the EMS deployment accuracy. Descriptive statistics were used to analyse the continuous and categorical variables, while Pearson’s chi-square test and ANOVA tests examined associations between call prioritisation decisions, on-scene resource allocation, and the qualifications of call takers and dispatchers. Results: Of the 535 records meeting the inclusion criteria, 71.1% revealed mismatches between call prioritisation and on-scene triage. The over-prioritisation rate was 90.9%, while the under-prioritisation rate was 17.1%. Additionally, 35.0% of patients were transported to a medical facility without receiving any medical interventions. Conclusion: Significant disparities exist between call prioritisation and actual patient clinical needs, exacerbating the strain on an already resource-constrained EMS system. Standardised call prioritisation protocols and improved training for call takers and dispatchers are necessary to enhance EMS efficiency.