Analyse von Hilfeersuchen

Zusammenfassung.

In Deutschland existieren unterschiedliche Notrufnummern, über die sowohl nicht dringliche Hilfeersuchen als auch Notrufe an die jeweiligen Einsatzzentralen gerichtet werden. Durch Weitervermittlung wird häufig wertvolle Zeit uneinholbar verloren. Mit einer viermonatigen, repräsentativen Analyse wurde daher das gesamte Anrufvolumen, der Anteil von Notrufen, der Anteil von Notrufweiterleitungen analysiert sowie das potentielle Anrufvolumen einer hypothetischen einheitlichen Notrufnummer errechnet. Insgesamt wurden 80 987 Anrufe, die zu 84,3% aus der Stadt Mainz stammten, registriert. Die meisten Anrufe gingen bei der Berufsfeuerwehr Mainz ein (33 086), gefolgt von der Rettungsleitstelle Mainz (31 286) und den Ärztlichen Notfalldienstzentralen (15 256). In dem Gesamtanrufaufkommen waren 3542 Notrufe enthalten (4,37%). 67% dieser Notrufe stammten aus dem Stadtgebiet. Im Stadtgebiet Mainz wurden außerhalb der Dienstzeiten des ärztlichen Notfalldienstes 51% der Notrufe primär an die Rettungsleitstelle gerichtet (Abb. 2). Während der Dienstzeiten der Ärztlichen Notfalldienstzentrale Mainz verringerte sich dieser Anteil auf 35%. Im Kreisgebiet erreichten während der Dienstzeiten der Ärztlichen Notfalldienstzentralen nur 14% der Notrufe primär die Rettungsleitstelle. Bei Hilfeersuchen an nur eine einheitliche Notrufzentrale wäre eine gleichmäßigere Auslastung der Leitstelle zu erwarten. Der Rettungsdienstbereich Mainz-Bingen mit insgesamt 13 verschiedenen Notrufnummern ist durchaus als typisch für die deutsche "Notrufvielfalt" anzusehen. Der hohe Anteil von Notrufen, die weitervermittelt werden mußten (bis zu 86%) zeigt, daß diese Schwachstelle des Rettungssystems nur mit einer einheitlichen Notrufzentrale und einer generellen Notrufnummer 112 beseitigt werden kann.

Abstract.

There is no doubt that a single emergency phone number is desirable, but in contrast to other countries, in Germany different emergency phone numbers and dispatching centers exist for the fire brigade (FB), the emergency medical service system (EMS), and the general practitioners' emergency service (GPS). Due to this fact, valuable time is often wasted by connecting or transferring emergency calls from one dispatching center to another. The purpose of this study was to analyse all calls received by the different dispatching centers in the city and county area of Mainz with respect to total number, fraction of emergency calls, and specificity. Further, the total number of calls potentially referring to a hypothetic single dispatching center with a general emergency phone number (112) was calculated. During a 4-month period, all telephone calls were registered and related to day, time, and origin of the call (city or county) and classified as non-urgent or emergency calls, calls appropriate to the dispatching center dialed, emergency calls to be transferred, or unspecific calls. A total of 80 987 calls were received (city area 84.3%, county area 15.7%), most of them directed to the FB of Mainz (33 086). The EMS dispatching center received 31 286 calls, the five GPS-centers 15 256 calls; 1359 emergency calls that were directed to the police or FB needed transfer to the EMS. During weekdays the EMS and FB received the most calls, with a reduced frequency on Saturdays and Sundays (Table 2). Nevertheless, the highest total numbers of calls were received on Saturdays due to multiple calls directed to the GPS. The FB had the highest specificity of calls; more than 50% of the calls to the GPS were unspecific (Fig. 1). Of all calls, 4.37% were classified as emergency calls; two-thirds of these came from the area of Mainz during the daytime. During off-duty hours of the GPS in the city, 51% of the emergency calls reached the EMS directly; 49% had to be connected by the police or FB. During duty hours of the GPS, the fraction of calls directed to the EMS decreased significantly to 35%. During duty hours of the GPS centers in the county area, only 14% of the urgent emergency calls reached the EMS dispatcher directly (Fig. 2). Compared to the multiple-center mode, a hypothetic single dispatching center for all systems would probably be followed by a slight increase in total number of calls due to the fact that the GPS numbers would be answered 24 h a day, but there would be only minimal differences in the total number received on most days; only on Sundays would a decrease be expected. The EMS area of Mainz, with a total of 13 different telephone numbers for 7 dispatching centers, can be regarded as typical of the German situation. The high number of emergency calls to be transferred (up to 86% under special circumstances) demonstrated that this weak point in the German EMS system must be eliminated by introducing a single emergency number. This should occur when a Europe-wide three-digit number "112" will be instituted, probably in 1995. Additionally, the continued existence of 5- or 10-digit telephone numbers for non-urgent calls may be useful for allowing non-verbal differentiation of calls. In any case, all telephone numbers, including the latter calls, have to enter one dispatching center. The main advantage of a single dispatching center would be avoidance of the time-consuming transfer of emergency calls from one dispatching center to the other.