Overview and Comparison of Physician Utilization in Prehospital Emergency Medical Services in Europe

Martin Dr. Rief



Background: National and regional systems for emergency medical care provision may differ greatly between each other. We sought to elucidate whether physicians are utilised in prehospital care in European countries and to what extent they are relied on.

Methods: Data of 32 European countries collected by review of published articles and by questionnaires sent to authors of relevant scientific articles, ministry of health (or equivalent) officials, representatives of national societies in emergency medicine, or known experts in emergency medicine were aggregated.

Results: 30 of 32 (94%) investigated European countries employ physicians in prehospital emergency medical services. In 17 of 32 (53%) of countries, general practitioners also participate in prehospital emergency care. EMS systems were described as Franco-German in 27 (84%), as Hybrid in 17 (53%), and as Anglo-American in 14 (44%) countries; in 17 (53%) countries, multiple archetypical classifications were considered appropriate. Using a novel tiered classification based on average population and area served per prehospital physician system, we were able to differentiate systems clearly.

Conclusions: There are notable differences in system designs and intensity of physician utilization between different geographic areas, countries, and regions in Europe. Several archetypal models (Franco-German, Hybrid, and Anglo-American) exist simultaneously throughout European countries.

Palabras Clave

Emergency Medical Services; Health Care Facilities, Manpower and Services; Physician’s role; Ambulances;