Association between the centralization of dispatch centers and dispatcher-assisted cardiopulmonary resuscitation programs

A natural experimental study

Young Sun Ro, Sang Do Shin, Seung Chul Lee, Kyoung Jun Song, Joo Jeong, Dae Han Wi, Sungwoo Moon

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: We aimed to evaluate the associations between the centralization of dispatch centers and dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) for out-of-hospital cardiac arrest (OHCA) patients. Methods: All emergency medical services (EMS)-treated adults in Gyeonggi province (34 fire departments covering 43 counties, with a population of 12.6 million) with OHCAs of cardiac etiology were enrolled between 2013 and 2016, excluding cases witnessed by EMS providers. In Gyeonggi province, 34 agency-based dispatch centers were sequentially integrated into two province-based central dispatch centers (north and south) between November 2013 and May 2016. Exposure was the centralization of the dispatch centers. Endpoint variables were BCPR and dispatcher-provided CPR instructions. Generalized linear mixed models for multilevel regression analyses were performed. Results: Overall, 11,616 patients (5060 before centralization and 6556 after centralization) were included in the final analysis. The OHCAs that occurred during the after-centralization period were more likely to receive BCPR (62.6%, 50.6% BCPR-with-DA and 12.0% BCPR-without-DA) than were those that occurred before-centralization period (44.6%, 16.6% BCPR-with-DA and 28.1% BCPR-without-DA) (p < 0.01, adjusted OR: 1.59 (1.38–1.83), adjusted rate difference: 9.1% (5.0–13.2)). For dispatcher-provided CPR instructions, OHCAs diagnosed at a higher rate during the after-centralization period than during the before-centralization period (67.4% vs. 23.1%, p < 0.01, adjusted OR: 4.57 (3.26–6.42), adjusted rate difference: 30.3% (26.4–34.2)). The EMS response time was not different between the groups (p=0.26). Conclusions: The centralization of dispatch centers was associated with an improved bystander CPR rate and dispatcher-provided CPR instructions for OHCA patients.

Original languageEnglish
Pages (from-to)29-35
Number of pages7
JournalResuscitation
Volume131
DOIs
StatePublished - 1 Oct 2018

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Cardiopulmonary Resuscitation
Emergency Medical Services
Out-of-Hospital Cardiac Arrest
Multilevel Analysis
Reaction Time
Linear Models
Regression Analysis
Population

Keywords

  • Bystander cardiopulmonary resuscitation
  • Cardiac arrest
  • Dispatch center

Cite this

@article{7aea16d952db47c38d63870db47b22e6,
title = "Association between the centralization of dispatch centers and dispatcher-assisted cardiopulmonary resuscitation programs: A natural experimental study",
abstract = "Objectives: We aimed to evaluate the associations between the centralization of dispatch centers and dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) for out-of-hospital cardiac arrest (OHCA) patients. Methods: All emergency medical services (EMS)-treated adults in Gyeonggi province (34 fire departments covering 43 counties, with a population of 12.6 million) with OHCAs of cardiac etiology were enrolled between 2013 and 2016, excluding cases witnessed by EMS providers. In Gyeonggi province, 34 agency-based dispatch centers were sequentially integrated into two province-based central dispatch centers (north and south) between November 2013 and May 2016. Exposure was the centralization of the dispatch centers. Endpoint variables were BCPR and dispatcher-provided CPR instructions. Generalized linear mixed models for multilevel regression analyses were performed. Results: Overall, 11,616 patients (5060 before centralization and 6556 after centralization) were included in the final analysis. The OHCAs that occurred during the after-centralization period were more likely to receive BCPR (62.6{\%}, 50.6{\%} BCPR-with-DA and 12.0{\%} BCPR-without-DA) than were those that occurred before-centralization period (44.6{\%}, 16.6{\%} BCPR-with-DA and 28.1{\%} BCPR-without-DA) (p < 0.01, adjusted OR: 1.59 (1.38–1.83), adjusted rate difference: 9.1{\%} (5.0–13.2)). For dispatcher-provided CPR instructions, OHCAs diagnosed at a higher rate during the after-centralization period than during the before-centralization period (67.4{\%} vs. 23.1{\%}, p < 0.01, adjusted OR: 4.57 (3.26–6.42), adjusted rate difference: 30.3{\%} (26.4–34.2)). The EMS response time was not different between the groups (p=0.26). Conclusions: The centralization of dispatch centers was associated with an improved bystander CPR rate and dispatcher-provided CPR instructions for OHCA patients.",
keywords = "Bystander cardiopulmonary resuscitation, Cardiac arrest, Dispatch center",
author = "Ro, {Young Sun} and Shin, {Sang Do} and Lee, {Seung Chul} and Song, {Kyoung Jun} and Joo Jeong and Wi, {Dae Han} and Sungwoo Moon",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.resuscitation.2018.07.034",
language = "English",
volume = "131",
pages = "29--35",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

Association between the centralization of dispatch centers and dispatcher-assisted cardiopulmonary resuscitation programs : A natural experimental study. / Ro, Young Sun; Shin, Sang Do; Lee, Seung Chul; Song, Kyoung Jun; Jeong, Joo; Wi, Dae Han; Moon, Sungwoo.

In: Resuscitation, Vol. 131, 01.10.2018, p. 29-35.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Association between the centralization of dispatch centers and dispatcher-assisted cardiopulmonary resuscitation programs

T2 - A natural experimental study

AU - Ro, Young Sun

AU - Shin, Sang Do

AU - Lee, Seung Chul

AU - Song, Kyoung Jun

AU - Jeong, Joo

AU - Wi, Dae Han

AU - Moon, Sungwoo

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Objectives: We aimed to evaluate the associations between the centralization of dispatch centers and dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) for out-of-hospital cardiac arrest (OHCA) patients. Methods: All emergency medical services (EMS)-treated adults in Gyeonggi province (34 fire departments covering 43 counties, with a population of 12.6 million) with OHCAs of cardiac etiology were enrolled between 2013 and 2016, excluding cases witnessed by EMS providers. In Gyeonggi province, 34 agency-based dispatch centers were sequentially integrated into two province-based central dispatch centers (north and south) between November 2013 and May 2016. Exposure was the centralization of the dispatch centers. Endpoint variables were BCPR and dispatcher-provided CPR instructions. Generalized linear mixed models for multilevel regression analyses were performed. Results: Overall, 11,616 patients (5060 before centralization and 6556 after centralization) were included in the final analysis. The OHCAs that occurred during the after-centralization period were more likely to receive BCPR (62.6%, 50.6% BCPR-with-DA and 12.0% BCPR-without-DA) than were those that occurred before-centralization period (44.6%, 16.6% BCPR-with-DA and 28.1% BCPR-without-DA) (p < 0.01, adjusted OR: 1.59 (1.38–1.83), adjusted rate difference: 9.1% (5.0–13.2)). For dispatcher-provided CPR instructions, OHCAs diagnosed at a higher rate during the after-centralization period than during the before-centralization period (67.4% vs. 23.1%, p < 0.01, adjusted OR: 4.57 (3.26–6.42), adjusted rate difference: 30.3% (26.4–34.2)). The EMS response time was not different between the groups (p=0.26). Conclusions: The centralization of dispatch centers was associated with an improved bystander CPR rate and dispatcher-provided CPR instructions for OHCA patients.

AB - Objectives: We aimed to evaluate the associations between the centralization of dispatch centers and dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) for out-of-hospital cardiac arrest (OHCA) patients. Methods: All emergency medical services (EMS)-treated adults in Gyeonggi province (34 fire departments covering 43 counties, with a population of 12.6 million) with OHCAs of cardiac etiology were enrolled between 2013 and 2016, excluding cases witnessed by EMS providers. In Gyeonggi province, 34 agency-based dispatch centers were sequentially integrated into two province-based central dispatch centers (north and south) between November 2013 and May 2016. Exposure was the centralization of the dispatch centers. Endpoint variables were BCPR and dispatcher-provided CPR instructions. Generalized linear mixed models for multilevel regression analyses were performed. Results: Overall, 11,616 patients (5060 before centralization and 6556 after centralization) were included in the final analysis. The OHCAs that occurred during the after-centralization period were more likely to receive BCPR (62.6%, 50.6% BCPR-with-DA and 12.0% BCPR-without-DA) than were those that occurred before-centralization period (44.6%, 16.6% BCPR-with-DA and 28.1% BCPR-without-DA) (p < 0.01, adjusted OR: 1.59 (1.38–1.83), adjusted rate difference: 9.1% (5.0–13.2)). For dispatcher-provided CPR instructions, OHCAs diagnosed at a higher rate during the after-centralization period than during the before-centralization period (67.4% vs. 23.1%, p < 0.01, adjusted OR: 4.57 (3.26–6.42), adjusted rate difference: 30.3% (26.4–34.2)). The EMS response time was not different between the groups (p=0.26). Conclusions: The centralization of dispatch centers was associated with an improved bystander CPR rate and dispatcher-provided CPR instructions for OHCA patients.

KW - Bystander cardiopulmonary resuscitation

KW - Cardiac arrest

KW - Dispatch center

UR - http://www.scopus.com/inward/record.url?scp=85051046408&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2018.07.034

DO - 10.1016/j.resuscitation.2018.07.034

M3 - Article

VL - 131

SP - 29

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JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -