Under resolutions passed by the German Bundestag, it has, since the mid 1970s, been standard to continuously record scientific data on the emergency medical system in the Federal Republic of Germany. The aim of the present analysis of the public-sector emergency medical system in the period 1996/7 is to provide a representative presentation of selected variables in order to enable rapid reactions to be made to possible changes. It was intended that the variables recorded related to the sequence of a rescue operation (speed and quality of rescue operation) and the development of the volume of operations (development of the emergency medical services). The conclusions reached in the investigation are based on the evaluation of documented rescue journeys. Thirteen characteristics are recorded in the case of each rescue journey; these provide a more detailed description of the temporal and spatial aspects of the rescue operation and of its specific structure (e.g. application of a law granting special privileges, unnecessary application of this law). In addition to obtaining a random sample which is representative both temporally and spatially, it is also necessary, subsequent to the selection procedure, to project the rescue operation data in a proper manner in order to reach conclusions regarding the efficiency of the emergency medical service in Germany relating to a particular year. Subsequent to the projection, the interrelationship of the recorded characteristics is analysed and an investigation is made into how the characteristics change over time. The present results of the projection for 1996/7 were based on consideration of 60 representatively selected emergency service areas in the new and old Länder. The result of the projection for the Federal Republic of Germany was that about 9 million rescue operations are carried out annually with a total of about 10.4 million rescue journeys by the state emergency medical services. On an average work day in the period 1996/7, the EMS communication centres received a total of about 28,000 calls for emergency medical services. On average, every communication centre carried out 4,500 journeys; about 1,400 journeys were made from emergency physician locations. This produces a rescue operation volume of 110.5 rescue operations per 1,000 inhabitants per year for the period covered which corresponds to a rise of 4.5 rescue operations per 1 000 inhabitants per year compared with the 1994/5 period. Pursuant to the emergency medical service laws of the Länder, these operations are divided into emergency rescue operations and the transportation of injured victims to hospitals. The number of emergency rescue operations (with / without the participation of an emergency physician) amounted in the period investigated to about 3.5 million annually. The division of the emergencies according to whether an emergency physician was involved shows that an emergency physician participated in around half of the emergency operations. The emergency physician rate amounted to 19.4 emergency alerts per 1,000 inhabitants. The calculation of the length of time required to reach the point at which assistance is required is based on the first means of rescue which reaches the scene and on the decision as to whether it is in actual fact an emergency under the law granting special privileges for the journey to the scene of an accident. This results in a national average for this length of time of 7.7 minutes. The average period for assistance to arrive at traffic accidents which occurred on roads inside built-up areas was 6.7 minutes during the day and 7.7 minutes at night. The average period for assistance to arrive at traffic accidents on roads outside built-up areas was 8.8 minutes during the day and 10.4 minutes at night. Appendices are attached to the original report which contain inter alia explanations on the methodology of the performance analysis, the form for recording the rescue operations, a list of the variables and the questionnaire "Data on the Infrastructure of the Emergency Medical Services". The appendices were not included in the present publication. They may however be consulted at the Federal Highway Research Institute. References to the appendices were therefore retained in the report. (Author/publisher)
Abstract