32 Sommer, Anja Beckers, Stefan Simon, Tim-Philipp 533000-2 ; 931210 Aachen Multiple 18, 10, 10 Seiten : Illustrationen, Diagramme Background: Prehospital emergency medical services (EMS) are increasingly under pressure, in Germany, but also at Euregional level. Reasons include the shortage of both resources and staff as well as steadily increasing numbers of EMS missions. The corona pandemic challenged the health care system and all its sectors and showed how essential innovative approaches are to ensure efficient use of scarce resources. Methods: 1) In a qualitative study about cross-border collaboration in the Euregio Meuse-Rhine (EMR: between Germany, Belgium and The Netherlands), 22 semi-structured interviews were carried out with experts in the field of prehospital EMS (including EMS management dispatch center staff, EMS medical directors, politicians, crisis management experts and intensive medicine staff). All interviews were transcribed, anonymized and if necessary, translated into English or German. Thematic coding and analysis took place afterwards. The results were structured into the two domains: direct EMS care and interhospital-transports (IHT). 2) Within a retrospective mixed-methods cross-sectional study, focus group interviews were undertaken with community paramedics [in German “Gemeindenotfallsanitäter” (G-NFS)] from the four regional groups (City of Oldenburg and districts of Vechta, Cloppenburg and Ammerland). After the interviews, a short anonymous survey was conducted with the same participants. Both the interviews and the survey had the goal of discussing the personal experiences of the G-NFS before and during the corona pandemic. The interview results were analyzed via thematic coding. Results: 1) Cross-border collaboration in the EMR has been identified by the participants as important and valuable. In the past cross-border collaboration took place regularly in EMS and IHT. However, with the onset of the corona pandemic, the local cross-border collaboration was hampered by national procedures leading to patients being transported to hospitals far outside the border regions. To function well, cross-border collaboration needs regular personal contact across working groups, the exchange of information and best-practices as well as formalized agreements, which need to be recognized at both national and international level. 2) Introducing G-NFS as a new resource in EMS leads to a useful relief for the overall EMS system. G-NFS can care for non-urgent patients adequately and with sufficient time. Moreover, intersectoral care can be ensured by the G-NFS and therefore, unnecessary transports of patients to the hospital are prevented. G-NFS could be dispatched to triage patients during the corona pandemic peaks. This would allow other EMS vehicles, such as emergency ambulances, to be more available and to cover genuine emergency cases. Discussion: Both studies show that an efficient and more needs-based use of resources within emergency care is essential for adequate and high-quality care of patients in today’s health care system. Although cross-border collaboration in the EMR has high potential for effective Euregional support, this has been inhibited by national guidelines, especially at the beginning of the pandemic. Consequently, the available resources in the border region were not being taken advantage of. On the other hand, the availability of G-NFS as a local care provision resource ensures patients are forwarded to the correct sector of care. Both the enhancement of intersectoral and cross-border care are necessary to relieve the burden on the overall system of emergency medical services and care. Dissertation, Rheinisch-Westfälische Technische Hochschule Aachen, 2023, Kumulative Dissertation ; 2, ; PUB:(DE-HGF)11, ; Dissertation / PhD Thesis Dissertation Rheinisch-Westfälische Technische Hochschule Aachen 2023 2023 RWTH-2023-10275 2023 https://publications.rwth-aachen.de/record/972604