Understanding Non-Transport Decision Theories in the Pre-hospital Setting: A Comprehensive Narrative Review

Abstract Background: Pre-hospital emergency calls do not always result in the patient being transported to the hospital. Such decisions can jeopardize healthcare outcomes and lead to wasting resources. Objectives and Methods: The purpose of this review was to summarize the various theories reported in the literature regarding patient non-conveyance to healthcare facilities in the pre-hospital emergency setting. Studies published between January 2012 and August 2022 were identified from PubMed and Google Scholar. These studies were subsequently screened using the AL-Rayyan ® software. Results and Discussion: Twenty-nine articles that summarized patient non-transport theories were identified. Patient non-transport is a crucial health issue. The factors related to the non-transport were: patient-initiated refusals (PIR), clinical-initiated decisions (CID), and dispatcher-initiated decisions (DID). Conclusions: Patient non-transport to hospitals remains a serious challenge for emergency care systems. Hence, it requires greater attention from different healthcare systems. Further analysis is necessary to understand pre-hospital non-transport events and identify improvement areas. This approach helps prevent the wastage of resources while ensuring that patients receive the appropriate and definitive care they require.