{"id":"https://openalex.org/W7223700682","doi":"https://doi.org/10.1093/eurpub/ckag169.874","title":"A three-layer framework for pre-hospital triage to reduce non-urgent emergency use in Germany","display_name":"A three-layer framework for pre-hospital triage to reduce non-urgent emergency use in Germany","publication_year":2026,"publication_date":"2026-10-01","ids":{"openalex":"https://openalex.org/W7223700682","doi":"https://doi.org/10.1093/eurpub/ckag169.874"},"language":"en","primary_location":{"id":"doi:10.1093/eurpub/ckag169.874","doi":"https://doi.org/10.1093/eurpub/ckag169.874","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.874","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.874/72464575/ckag169.874.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.874/72464575/ckag169.874.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5159686537","display_name":"SS Moturi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I54738626","display_name":"University of Applied Sciences Europe","ror":"https://ror.org/041w2kh96","country_code":"DE","type":"education","lineage":["https://openalex.org/I54738626"]}],"countries":["DE"],"is_corresponding":true,"raw_author_name":"SS Moturi","raw_affiliation_strings":["International Public Health Management, University of Europe for Applied Sciences , Iserlohn,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"International Public Health Management, University of Europe for Applied Sciences , Iserlohn,","institution_ids":["https://openalex.org/I54738626"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5159686537"],"corresponding_institution_ids":["https://openalex.org/I54738626"],"apc_list":{"value":2815,"currency":"EUR","value_usd":3181},"apc_paid":{"value":2815,"currency":"EUR","value_usd":3181},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.84567662,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"Supplement_5","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.000699999975040555,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/prehospital-triage","display_name":"prehospital triage","score":0.9789999723434448},{"id":"https://openalex.org/keywords/emergency-department-use","display_name":"emergency department utilization","score":0.7789999842643738},{"id":"https://openalex.org/keywords/patient-navigation","display_name":"patient navigation","score":0.5759999752044678},{"id":"https://openalex.org/keywords/care-pathways","display_name":"care pathways","score":0.7400000095367432},{"id":"https://openalex.org/keywords/telemedicine","display_name":"telemedicine","score":0.6890000104904175},{"id":"https://openalex.org/keywords/primary-care-linkage","display_name":"primary care linkage","score":0.9539999961853027},{"id":"https://openalex.org/keywords/digital-exclusion","display_name":"digital exclusion","score":0.6010000109672546},{"id":"https://openalex.org/keywords/health-equity","display_name":"health equity","score":0.8040000200271606},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.7009999752044678},{"id":"https://openalex.org/keywords/interoperability","display_name":"interoperability","score":0.6380000114440918}],"concepts":[{"id":"https://openalex.org/C2777120189","wikidata":"https://www.wikidata.org/wiki/Q780067","display_name":"Triage","level":2,"score":0.8472999930381775},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5246000289916992},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.5016999840736389},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4399999976158142},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.4115000069141388},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.37860000133514404},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.36970001459121704},{"id":"https://openalex.org/C153083717","wikidata":"https://www.wikidata.org/wiki/Q6535263","display_name":"Leverage (statistics)","level":2,"score":0.3675000071525574},{"id":"https://openalex.org/C86251818","wikidata":"https://www.wikidata.org/wiki/Q816754","display_name":"Benchmarking","level":2,"score":0.3253999948501587},{"id":"https://openalex.org/C19527686","wikidata":"https://www.wikidata.org/wiki/Q1665453","display_name":"System integration","level":2,"score":0.30320000648498535},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.29600000381469727},{"id":"https://openalex.org/C2777896688","wikidata":"https://www.wikidata.org/wiki/Q3773715","display_name":"Clinical governance","level":3,"score":0.29280000925064087},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.28859999775886536},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.28850001096725464},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.2863999903202057},{"id":"https://openalex.org/C39389867","wikidata":"https://www.wikidata.org/wiki/Q380767","display_name":"Corporate governance","level":2,"score":0.2856999933719635},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.28040000796318054},{"id":"https://openalex.org/C26713055","wikidata":"https://www.wikidata.org/wiki/Q245962","display_name":"Implementation","level":2,"score":0.2802000045776367},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.2623000144958496},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.26159998774528503},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.25589999556541443},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.2540000081062317},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.25360000133514404},{"id":"https://openalex.org/C2777880217","wikidata":"https://www.wikidata.org/wiki/Q4674282","display_name":"Acknowledgement","level":2,"score":0.25049999356269836}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/eurpub/ckag169.874","doi":"https://doi.org/10.1093/eurpub/ckag169.874","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.874","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.874/72464575/ckag169.874.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13699209","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13699209/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13699209/pdf/ckag169.874.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Eur J Public Health","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/eurpub/ckag169.874","doi":"https://doi.org/10.1093/eurpub/ckag169.874","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.874","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.874/72464575/ckag169.874.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.98580002784729,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"},{"score":0.7307999730110168,"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223700682.pdf"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7211932962","https://openalex.org/W4404001734","https://openalex.org/W7203602454","https://openalex.org/W7095031440","https://openalex.org/W4412630524","https://openalex.org/W4407599251","https://openalex.org/W7169820099","https://openalex.org/W7171418088","https://openalex.org/W7166714373","https://openalex.org/W7171968797"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Emergency":[2],"departments":[3],"in":[4,26,276],"Germany":[5],"and":[6,29,74,111,113,121,131,154,178,183,212,226,231,248,268],"across":[7,128,233],"Europe":[8],"continue":[9],"to":[10,65,108,139,208,278],"experience":[11],"inappropriate":[12],"utilisation":[13],"by":[14,252],"non-urgent":[15,67],"cases":[16],"despite":[17],"established":[18],"primary":[19,109],"care":[20,87,110,210,257],"pathways.":[21],"This":[22],"reflects":[23],"persistent":[24],"gaps":[25],"patient":[27,86,246],"navigation":[28,211,247],"decision-making":[30,254],"before":[31,142,255],"care-seeking.":[32],"AI-supported":[33,58,169,200],"triage":[34,60,170,202,263],"has":[35],"emerged":[36],"as":[37],"a":[38,53,204],"potential":[39],"upstream":[40],"intervention":[41,207],"but":[42],"lacks":[43],"structured":[44,83,241],"integration":[45,96,118],"into":[46,61,119],"public":[47],"health":[48,92,235],"systems.":[49,236],"Objectives":[50],"To":[51],"develop":[52],"system-level":[54],"framework":[55,97,125,135],"for":[56,160],"integrating":[57],"pre-hospital":[59,201],"healthcare":[62],"access":[63,101,277],"pathways":[64,88],"reduce":[66,213,249],"emergency":[68,143,215,256],"department":[69,144],"utilisation.":[70],"Methods":[71],"A":[72,94,163,240],"policy":[73],"systems":[75],"analysis":[76],"was":[77,98,126],"conducted,":[78],"combining":[79,191],"evidence":[80],"synthesis":[81],"with":[82,194],"mapping":[84],"of":[85],"within":[89,220],"the":[90],"German":[91],"system.":[93],"three-layer":[95,242],"developed:":[99],"(1)":[100],"(digital":[102],"entry-point":[103],"triage),":[104],"(2)":[105],"routing":[106],"(linkage":[107],"telehealth),":[112],"(3)":[114],"system":[115,250],"feedback":[116],"(data":[117],"planning":[120],"resource":[122],"allocation).":[123],"The":[124,134],"assessed":[127],"feasibility,":[129],"safety,":[130,225],"equity.":[132],"Results":[133],"identifies":[136],"leverage":[137],"points":[138],"redirect":[140],"patients":[141,267],"entry.":[145],"Key":[146,237],"success":[147],"factors":[148],"include":[149],"interoperability,":[150],"clear":[151],"escalation":[152],"protocols,":[153],"risk":[155],"stratification":[156],"safeguards,":[157,261],"including":[158],"thresholds":[159],"high-risk":[161,266],"cases.":[162],"central":[164],"trade-off":[165],"is":[166],"identified:":[167],"while":[168],"may":[171,264],"improve":[172,209,245],"efficiency,":[173],"it":[174],"risks":[175],"reinforcing":[176],"inequities":[177,275],"misclassification":[179],"if":[180],"digital":[181,192],"exclusion":[182],"governance":[184],"challenges":[185],"are":[186,197],"not":[187],"addressed.":[188],"Hybrid":[189],"models":[190],"tools":[193,219],"human":[195],"support":[196],"critical.":[198],"Conclusions":[199],"represents":[203],"feasible":[205],"systems-level":[206],"unnecessary":[214],"use.":[216,258],"Embedding":[217],"such":[218],"existing":[221],"structures\u2014while":[222],"addressing":[223],"equity,":[224],"governance\u2014will":[227],"determine":[228],"their":[229],"impact":[230],"transferability":[232],"European":[234],"messages":[238],"\u2022":[239,259],"approach":[243],"can":[244],"inefficiencies":[251],"shifting":[253],"Without":[260],"AI":[262],"misclassify":[265],"exclude":[269],"digitally":[270],"disadvantaged":[271],"groups,":[272],"potentially":[273],"worsening":[274],"care.":[279]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-27T00:00:00"}