Characteristics and Outcomes of Patients Assessed by Paramedics and Not Transported to Hospital: A Pilot Study


Key words
emergency medical technician
emergency medicine

How to Cite

Keene T, Davis M, Brook C. Characteristics and Outcomes of Patients Assessed by Paramedics and Not Transported to Hospital: A Pilot Study. Australasian Journal of Paramedicine [Internet]. 2015May4 [cited 2021Dec.4];12(2). Available from:



Patients seen by ambulance paramedics but not transported to hospital have not previously been studied in Australia. The purpose of this pilot study is to determine the feasibility of telephone interviews to describe and analyse patient factors, and determine short term patient outcomes associated with paramedic no-transport decisions.


Twenty (20) patients participated in semi-structured telephone interviews 13-30 days following an episode of care from an Australian urban ambulance service. Data analysis was conducted in two phases; firstly, a quantitative description of the patient characteristics and their outcomes; and secondly, a qualitative analysis using a thematic framework to determine if there were any common themes emerging from the interviews.


Only three (3) patients refused to participate in the interviews and none were unable to be located. The reasons patients expressed for not accepting transport were varied, though a common factor related to patient expectations of the service provided by paramedics. Patients had poor recall of advice provided by paramedics. All except one patient were successfully diverted from the emergency health system. Overall, patients expressed high satisfaction with their experience.


The reasons patients choose for not being transported require further study but appear to be driven by their expectations of the service provided by Paramedics. Telephone interviews are a viable method for collecting data on non-transported ambulance patients.


Brown LH, Hubble MW, Cone DC, et al. Paramedic determinations of medical necessity: A meta-analysis. Prehosp Emerg Care 2009;13:516–27.

Hauswald M. Can paramedics safely decide which patients do not need ambulance transport or emergency department care? ibid. 2002;6:383–6.

Kahale J, Osmond MH, Nesbitt L, Stiell IG. What are the characteristics and outcomes of nontransported pediatric patients? ibid.2006;10:28–34.

Staudenmayer K, Hsia R, Wang E, et al. The forgotten trauma patient: Outcomes for injured patients evaluated by emergency medical services but not transported to hospital. J Trauma 2012;72:594–600.

Burstein JL, Henry MC, Alicandro J, Gentile D, Thode HC, Hollander JE. Outcome of patients who refused out-of-hospital medical assistance. Am J Emerg Med 1996;14:23–6.

Knight S, Olson LM, Cook LJ, Mann NC, Corneli HM, Dean JM. Against all advice: An analysis of out-of-hospital refusals of care. Ann Emerg Med 2003;42:689–96.

Pringle RP, Carden DL, Xiao F, Graham DD. Outcomes of patients not transported after calling 911. J Emerg Med 2005;28:449–54.

Justice and Community Safety Directorate (2014). Annual Report: 2013-2014. ACT Government: Canberra.

Ritchie J, Spencer L. ‘Qualitative data analysis for applied policy research’. In: Bryman A, Burgess RG, eds. Analysing qualitative data. London: Routledge; 1994:173–94.

Grantham H, Hein C, Elliott R. South Australian Ambulance Service (SAAS) Extended Care Paramedic (ECP) Pilot Project. Journal of Emergency Primary Health Care 2010;8.

Mason S, Knowles E, Colwell B, et al. Effectiveness of paramedic practitioners in attending 999 calls from elderly people in the community: cluster randomised controlled trial. BMJ 2007;335:919.

Swain A, Hoyle S, Long A. The changing face of prehospital care in New Zealand: the role of extended care paramedics. N Z Med J 2010;123:11–4.

Schmidt A, Mann C, Federiuk C, et al. Do patients refusing transport remember descriptions of risks after initial advanced life support assessment. Acad Emerg Med 1998;5:796–801.