Background: Ambulance service performance measurement has previously focused on response times and survival. We conducted a systematic review of the international literature on quality measures and outcomes relating to pre-hospital ambulance service care, aiming to identify a broad range of outcome measures to provide a more meaningful assessment of ambulance service care.udMethods: We searched a number of electronic databases including CINAHL, the Cochrane Library, EMBASE, Medline, and Web of Science. For inclusion, studies had to report either research or evaluation conducted in a pre-hospital setting, published in the English language from 1982 to 2011, and reporting either outcome measures or specific outcome instruments.udResults: Overall, 181 full-text articles were included: 83 (46%) studies from North America, 50 (28%) from Europe and 21 (12%) from the UK. A total of 176 articles were obtained after examining 257 full-text articles in detail from 5,088 abstracts screened. A further five papers were subsequently identified from references of the articles examined and studies known to the authors. There were 140 articles (77%) which contained at least one survival-related measure, 47 (34%) which included information about length of stay and 87 (48%) which identified at least one place of discharge as an outcome.udLimitations: We encountered the problem of incomplete information, for instance studies not specifying which pain scales when these had been used or using survival without a specific time period. udConclusion and recommendations: In addition to measures relating to survival, length of stay and place of discharge, we identified 247 additional outcome measures. Few studies included patient reported or cost outcomes. By identifying a wide range of outcome measures this review will inform further research looking at the feasibility of using a wider range of outcome measures and developing new outcome measures in prehospital research and quality improvement.
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机译：背景：救护车服务性能的评估以前集中在响应时间和生存率上。我们对有关医院前救护车服务质量的质量度量和结果的国际文献进行了系统的回顾，旨在确定广泛的结果指标，以便对救护车服务进行更有意义的评估。 udMethods：我们搜索了许多电子数据库，包括CINAHL，Cochrane图书馆，EMBASE，Medline和Web of Science。为了纳入研究，研究必须报告在院前环境中进行的研究或评估，并于1982年至2011年以英语发布，并报告结果测量或特定的结果工具。 ud结果：总体上，共有181篇全文文章包括：来自北美的83项研究（46％），来自欧洲的50项研究（28％）和来自英国的21项（12％）。从筛选的5,088个摘要中详细检查了257篇全文文章后，总共获得176篇文章。随后从所检查文章的参考文献和作者已知的研究中确定了另外五篇论文。有140篇文章（77％）包含至少一项与生存相关的措施，其中47篇（34％）包括有关住院时间的信息，而87篇（48％）指出至少一个出院地点是结果。 udLimitations ：我们遇到了信息不完整的问题，例如，研究未指定使用哪种疼痛量表或在没有特定时间段的情况下使用生存率。 ud结论和建议：除了与生存率，住院时间和出院地点有关的指标外，我们还确定了247项其他结果指标。很少有研究包括患者报告或费用结果。通过确定范围广泛的结果指标，本综述将为进一步的研究提供参考，从而探讨在院前研究和质量改善中使用更广泛的结果指标并开发新的结果指标的可行性。
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