Publication: A Thailand case study based on quantitative assessment: does a national lead agency make a difference in pre-hospital care development in middle income countries?
Issued Date
2014
Resource Type
Language
eng
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. Vol. 22, (2014), 75
Suggested Citation
Paibul Suriyawongpaisal, Wichai Aekplakorn, Rassamee Tansirisithikul A Thailand case study based on quantitative assessment: does a national lead agency make a difference in pre-hospital care development in middle income countries?. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. Vol. 22, (2014), 75. doi:10.1186/s13049-014-0075-x Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2706
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
A Thailand case study based on quantitative assessment: does a national lead agency make a difference in pre-hospital care development in middle income countries?
Abstract
Background: Emergency Medical Institute of Thailand (EMIT) has been established as a national lead agency to
improve emergency medical service systems since December 2008. However up to now, there has not been any
published systematic assessment of its performance to guide further policy decisions.
Methods: This study assesses the 4-year pre-hospital care coverage and performance in Thailand after EMIT
establishment. The assessment makes use of 1,171,564 records from a national data set for pre-hospital care i.e.,
Information Technology for Emergency Medical Service System (ITEMS) in 2012.
Results: Comparing with historical data, we found evidence indicating the national lead agency making differences
in two basic requirements of pre-hospital care i.e., the coverage was increased by at least 1.4 times higher than the
majority reported figures among 11 out of the total 13 regions of the country at baseline; and mean total response
time for critical-coded patients, the longest in our study, is 1.6 times shorter than previously reported figure in 2008
(48.46 minutes). Analysis of the national data set also revealed quite substantial missing values indicating a need for
further improvement. When historical data was not available, we compared our findings with international figures.
Over triage rate of 28.4% for advanced life support (ALS) ambulance was found which is roughly a third of that
reported in Taiwan. Almost all patients were stabilized and/or treated regardless of being transferred to hospitals in
contrast to the scenarios in the U.S. systems which may probably be due to different payment mechanism. Relying
on circumstantial evidences, we identified probable stagnation in pre-hospital care coverage for patients visiting
emergency department after the establishment of the lead agency.
Conclusions: This national data assessment shows progression in certain basic pre-hospital care requirements in
Thailand. However, it needs regular systematic evaluation and there is still room for improvement of pre-hospital
care systems such as increasing coverage, more equitable distribution of the coverage, faster response times,
especially for patients with critical code, information system, cost-effectiveness study as well as further specific
qualitative researches to guide further development of policy and intervention.