Location-based response times of emergency physicians in rural Germany: an observational study.

Background: The number of emergency callouts in Germany has doubled in the last 20 years. The shortage of doctors and social developments have led to challenges in ensuring emergency medical services and to temporary closures of entire emergency medical service areas. Stationing the emergency doctor on duty in the home environment is one option for making emergency medical services more attractive and could help to alleviate the problem of staff scheduling.

Objective: The response times of emergency physicians stationed in their home environment were compared with those of emergency doctors stationed at hospitals or rescue stations.

Methods: The response intervals and arrival times at the patient's location were statistically analyzed depending on the physician's location and distance from the rescue station. A support vehicle was used to reduce response times. The emergency physician met the full-time emergency vehicle at predefined points depending on the direction of the call.

Results: The response interval from the emergency station was 2.2 ± 1.0 min, from the hospital 3.1 ± 1.2 min and from the home environment 3.8 ± 1.6 min (p < 0.0001/Kruskal-Wallis test). In terms of the time taken to reach the patient, there was a significant advantage (p < 0.0001/Kruskal-Wallis test) in the group of call-outs from the rescue station (8,6 ± 3,9 min min. 2 and max. 23 min) compared to call-outs from the hospital (10.0 ± 4.4 min; min. 2 and max. 31 min) and the home environment (10.2 ± 4.2; min. 2 max. 33 min), with the difference between the hospital and the home environment not being significant at p = 0.256 (Kruskal-Wallis test). The actual distance of the emergency physician from the rescue station provides the best results for modeling response interval and showed no significant difference compared to being stationed at the hospital in terms of time to arrival at the scene for distances less than 3 km (p < 0.0001/Kruskal-Wallis test).

Conclusions: Stationing the emergency doctor in a domestic environment with a support vehicle and establishing fixed meeting points with the full-time emergency vehicle shows no disadvantage compared to stationing the emergency doctor in the hospital.