"Factors of EMS utilization" by Sherin Ibrahem, Waraporn Boonchieng et al.
  •  
  •  
 

Abstract

Background: The Emergency Medical Services (EMS) system is a network of coordinated medical service providers and resources that respond to medical emergencies. The Thai government implemented a national plan aimed to develop of the EMS services system. To our knowledge, there was little or no previous research about the factors associated with services use. The study aimed to explore the factors associated with using EMS services in Chiang Mai province, Thailand.

Method: The cross-sectional study was conducted in Chiang Mai province, Thailand. The first step was the selection of covariates associated with the using EMS/ ambulance services using simple logistic regression. The final step of model selection was confirmation of the factors’ association with each outcome using multivariable logistic regression.

Results: The study population consisted of 579 individuals. Nearly half of ED users (46.45%, n = 269) arrived at emergency departments (EDs) by EMS transport or ambulance, while 53.36% (n = 309) used other means of transportation. The mean age of EMS-users was 43.23 (15.89) years, and 43.63 (16.78) years for non-users. Variables associated with using EMS services included educational level, level of district urbanization, patient symptoms, familiarity with the Thai emergency telephone number (1669), and ambulance service fees.

Conclusion: These results imply that EMS utilization has a multifaceted nature which require addressing various determinants to optimize access and enhance patient awareness during emergencies. Improving patient access and awareness can ultimately lead to more efficient emergency response and improved healthcare outcomes.

Keywords: Emergency Medical System, Ambulance service, Medical emergency, Thailand

References

[1] Delaney PG, Moussally J, Wachira BW. Future directions for emergency medical services development in low- and middle-income countries. Surgery 2024;176(1):220-2. https://doi.org/10.1016/j.surg.2024.02.030.

[2] Brice SN, Boutilier JJ, Gartner D, Harper P, Knight V, Lloyd J, et al. Emergency services utilization in Jakarta (Indonesia): a cross-sectional study of patients attending hospital emergency departments. BMC Health Serv Res 2022;22(1):639. https://doi.org/10.1186/s12913-022-08061-8.

[3] Da P, Kurmapu J, Baig W, Pandian P, Morshidi F, Chiang M, et al. How do patients come to the accident and Emergency Department of RIPAS Hospital? Brunei Int Med J 2012;8:117-21.

[4] Zia N, Shahzad H, Baqir S, Shaukat S, Ahmad H, Robinson C, et al. Ambulance use in Pakistan: an analysis of surveillance data from emergency departments in Pakistan. BMC Emerg Med 2015;15(Suppl 2):S9. https://doi.org/10.1186/1471-227X-15-S2-S9.

[5] Park SJ, Kim JY, Yoon YH, Lee ES, Kim HJ, Kim SB, et al. Analysis of the Adequacy of Prehospital Emergency Medical Services Use of Patients Who Visited Emergency Departments in Korea from 2016 to 2018: Data from the National Emergency Department Information System. Emerg Med Int 2021;2021:6647149. https://doi.org/10.1155/2021/6647149.

[6] Shrestha SK, Koirala K, Amatya B. Patient's Mode of Transportation Presented in the Emergency Department of a Tertiary Care Centre, Kavre, Nepal. Kathmandu Univ Med J 2018;16(61):39-42.

[7] Ravindra P, Bhat R, Karanth N, Wilson W, Lavanya BN, Umra S, et al. Patterns and Predictors of Emergency Medical Services Utilisation by Patients Attending the Emergency Medicine Department of a Tertiary Care Hospital in India. J Emergencies, Trauma, Shock 2022;15(2):99-104. https://doi.org/10.4103/jets.jets_83_21.

[8] Phungoen P, Cheung LW, Ienghong K, Apiratwarakul K. Characteristics and Outcomes of Patient Transport to the Hospital by Emergency Medical Services (EMS); a Crosssectional Study. Arch Acad Emerg Med 2023;11(1):e69. https://doi.org/10.22037/aaem.v11i1.2112.

[9] Ringgren KB, Mills EHA, Christensen EF, Mortensen RN, Torp-Pedersen C, Kragholm KH. Mortality and return to work in patients transported by emergency ambulance after involvement in a traffic accident. BMC Emerg Med 2020;20(1):90. https://doi.org/10.1186/s12873-020-00382-3.

[10] Sungbun S, Tangkawanich T, Thanakumma O, Sukrueangkul A. Perceived barrier in accessing emergency medical services of ethnic groups in the highlands of Chiang Rai Province, Thailand. J Health Sci Med Res 2020;38(2):125-33.

[11] Suriyawongpaisal P, Tansirisithikul R, Srithamrongsawat S. An assessment on Thai emergency medical services performance: the patient perspective. J Med Assoc Thai 2012;95(1): 111-8.

[12] Sirikul W, Piankusol C, Wittayachamnankul B, Riyapan S, Supasaovapak J, Wongtanasarasin W, et al. A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand. Resusc Plus 2022;9:100196. https://doi.org/10.1016/j.resplu.2021.100196.

[13] Alanazy ARM, Wark S, Fraser J, Nagle A. Factors Impacting Patient Outcomes Associated with Use of Emergency Medical Services Operating in Urban Versus Rural Areas: A Systematic Review. Int J Environ Res Publ Health 2019;16(10):1728. https://doi.org/10.3390/ijerph16101728.

[14] Yuan J, Shan GL, Li SD, Gao CP, Cui LY, Peng B. Risk Factors Influencing Seeking Emergency Medical Service in Urban and Rural China Among Participants With a Previous Transient Ischemic Attack. Front Neurol 2021;11:620157. https://doi.org/10.3389/fneur.2020.620157.

[15] Shin SD, Ong ME, Tanaka H, Ma MH, Nishiuchi T, Alsakaf O, et al. Comparison of emergency medical services systems across Pan-Asian countries: a Web-based survey. Prehosp Emerg Care 2012;16(4):477-96. https://doi.org/10.3109/10903127.2012.695433.

[16] Beillon LM, Suserud BO, Karlberg I, Herlitz J, Beillon LM, Suserud BO, et al. Does ambulance use differ between geographic areas? A survey of ambulance use in sparsely and densely populated areas. Am J Emerg Med 2009;27(2):202-11. https://doi.org/10.1016/j.ajem.2008.01.012.

[17] Ratnayake A, Nakahara S, Bagaria D, De Silva S, De Silva SL, Llaneta A, et al. Focused research in emergency medical systems in Asia: A necessity for trauma system advancement. Emerg Crit Care Med 2022;2(2):87-93. https://doi.org/10.1097/EC9.0000000000000042.

[18] Monsomboon A, Chantawatsharakorn P, Suksuriyayothin S, Keorochana K, Mukda A, Praphruetkit N, et al. Prevalence of emergency medical service utilisation in patients with out-of-hospital cardiac arrest in Thailand. Emerg Med J 2016;33(3):213-7. https://doi.org/10.1136/emermed-2015-204818.

[19] Roudsari BS, Nathens AB, Arreola-Risa C, Cameron P, Civil I, Grigoriou G, et al. Emergency Medical Service (EMS) systems in developed and developing countries. Injury 2007;38(9):1001-13. https://doi.org/10.1016/j.injury.2007.04.008.

[20] Wright Nee Blackwell R, Carden DL, Hess EP, Booker-Vaughns J, Dunn P, Kizzie-Gillett C, et al. Adapting Conceptual Frameworks for Patient Engagement in Emergency Department Research. Acad Emerg Med 2016;23(12):1332-6. https://doi.org/10.1111/acem.13066.

[21] Yan J. Cognitive impairment analysis of public health emergencies from cognitive psychology perspective. CNS Spectr 2023;28(S2):S140. https://doi.org/10.1017/S1092852923006077.

[22] Qui~nones C, Shah MI, Cruz AT, Graf JM, Mondragon JA, Camp EA, et al. Determinants of Pediatric EMS Utilization in Children with High-Acuity Conditions. Prehosp Emerg Care 2018;22(6):676-90. https://doi.org/10.1080/10903127.2018.1445330.

[23] Poomsaidorn S, Laohasiriwong W, Soeung K. Prehospital emergency medical services utilization for critical patients and its determinants in Thailand. J Southwest Jiaot Univ 2021;56:514-23.

[24] Alabdali AA, Alfraidi AA, Almuhanna AA, Alhamdan AS, Alharbi AO, Alshaqha AA, et al. Public awareness of emergency medical services phone number. SJEMed 2021;2(2):147-52. https://doi.org/10.24911/SJEMed/72-1595710177.

[25] Olani A, Beza Demisse L, Alemayehu M, Sultan M. Factors Associated with Willingness to Call Emergency Medical Services for Worsening Symptoms of COVID-19 in Addis Ababa, Ethiopia. Open Access Emerg Med 2022;14:563-72. https://doi.org/10.2147/OAEM.S380566.

[26] Wirtu R, Yeshanew S, Geda A. Utilization of Ambulance Services and Associated Factors during Pregnancy and Labor Among Lactating Mothers in Buno Bedele Zone, Southwest Ethiopia. Health Serv Insights 2023;16:11786329231157227. https://doi.org/10.1177/11786329231157227.

[27] Durant E, Fahimi J. Factors associated with ambulance use among patients with low-acuity conditions. Prehosp Emerg Care 2012;16(3):329-37. https://doi.org/10.3109/10903127.2012.670688.

Download

Plum Print visual indicator of research metrics
PlumX Metrics
  • Usage
    • Downloads: 142
    • Abstract Views: 84
see details

Share

COinS