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Overtriage and undertriage in a prehospital system over 7 years


The Novara 118 emergency medical system (EMS) dispatch center manages medical emergency calls coming from a region that spreads out over 1,400 km2 and includes 88 towns and a population of 385,000 people; inhabitant density is 275 inhabitants/km2.


Data collection from 1 January 2005 to 31 December 2011 was obtained (EMS software SaveOnLine® Suite 4; REGOLA s.r.l., Turin, Italy). Triage used was the Medical Priority Dispatch System and severity was defined by color codes.


During the study period the Novara 118 dispatch center managed a total of 122,384 EMS interventions. Median (interquartile) overestimation (regardless of severity) was 10.0% (2.4 to 14.1%) while median underestimation was 1.5% (0.8 to 2.5%). See Tables 1 and 2.


Overall there were no statistical differences between the observation years either for overtriage or undertriage. When observed individually, trauma showed the only significant overtriage reduction over time; there were no individual modifications in undertriage over time.

Table 1 Overtriage (%)
Table 2 Undertriage (%)


  1. Neely KW, Eldurkar JA, Drake ME: Acad Emerg Med. 2000, 7: 174-180. 10.1111/j.1553-2712.2000.tb00523.x

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Carenzo, L., Barra, F., Messina, A. et al. Overtriage and undertriage in a prehospital system over 7 years. Crit Care 17 (Suppl 2), P276 (2013).

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