An assessment on Thai emergency medical services performance: The patient perspective

Abstract

Background: Emergency medical services (EMS) have been steadily developed in Thailand. However, the patient perspective has not been explicitly considered in performance assessment thus far although it is a key consideration for quality improvement in public organizations. Objective: To investigate the Thai patient experience in EMS and emergency departments (ED) and help Thai leaders guide future improvements. Material and Method: The present study was a survey of selected ED of 14 public hospitals in four geographical regions. Five hundred fifty patients from each hospital were interviewed between June and July 2009. The data were collected by medical records review and face-to-face interview. Results: Six thousand four hundred forty four patients [average age of 36.01 years (range: 0-98), almost 50% female, 95% local residents] participated in the survey. Ambulances staffed with paramedics or trained volunteers transported 7.28% of the patients. Of those, 80% to 95% were satisfied, rating the service as 'safe'. Volunteer transfers had lower satisfaction scores. Patients spent an average of 63.8 minutes in the ED. Almost all patients were satisfied and would recommend the services to their friends or relatives. The most common factors contributing to dissatisfaction were with waiting time for consultation and pain management. Conclusion: There is high patient satisfaction with emergency services in public hospitals. Nonetheless, the lower satisfaction for volunteer ambulance service, the concern about waiting time, and pain management highlights opportunity for improvement. The rapid, low-cost patient surveys combined with paper-based medical record review can yield useful information for quality improvements.