Emergency medicine physician-led care at the patient's residence: a cohort study of a mobile emergency unit.

BACKGROUND

Emergency departments (EDs) are often overcrowded. Older adults, who are frequently multimorbid and resource-intensive, represent a growing share of acute care demand. In Denmark, mobile emergency units (MEUs) provide emergency physician-led assessment and initial treatment in the patient's residence to potentially reduce avoidable hospital transfers. However, data on real-world service delivery and medium-term outcomes after MEU contacts remain limited.

METHODS

We conducted a retrospective, single-centre cohort study of MEU contacts within the Esbjerg Hospital catchment area (Region of Southern Denmark) from 1 September 2023 to 31 December 2024. Using the hospital's electronic health record, we extracted demographics, comorbidities, on-scene diagnostics and treatments, and patient disposition, and descriptively summarised immediate disposition at the index encounter, service delivery, and 180-day all-cause mortality without risk adjustment.

RESULTS

The cohort comprised 1,987 MEU contacts corresponding to 1,336 unique patients, with a median (interquartile range) age of 80.9 (71.1-87.9) years. Nearly one-third had ≥ 3 comorbidities. Point-of-care testing and ultrasound were used frequently (60.5% and 24.8%, respectively), and on-scene therapies were commonly administered (antibiotics 31.6%, intravenous fluids 18.0%, and analgesia 9.0%). 82.7% of contacts were managed at home without hospital conveyance at the index encounter, while the remaining contacts were directly admitted to hospital from the scene. 443 (33.2%) of the 1,336 unique patients died within 180 days.

CONCLUSIONS

MEU home visits involved bedside diagnostics and on-scene treatments, and most contacts were managed at home without conveyance at the index encounter. Mortality over 180 days was substantial and should be interpreted cautiously in this older, multimorbid cohort. The descriptive, unadjusted design precludes causal inference regarding safety or effectiveness.