Development of the Emergency Medical Service System Model for Critically Emergency Patients to Access Services: Case Study of Suphanburi Province

Abstract

The establishment of an emergency medical service system (EMSS) aimed at ensuring critically ill patients can access timely care is essential to reducing mortality and disability. This study focuses on developing an efficient model for organizing emergency medical service within Suphanburi Province, Research and Development (R&D) approach. Finding In 2022, it was observed that emergency response within the province faced significant challenges, with a high mortality rate for out-of-hospital emergency cases and only 28.10% of critical patients receiving emergency services promptly. The main causes were that most people were unaware of emergency medical services, the operational and management level of the emergency medical system was at the "operating and beginning to output" level, and emergency operations covered only 23% of all sub-district. The improvement of governance mechanisms in the EMSS is proposed through a two-phase approach, encompassing both long-term and transitional strategies. In the long-term, EMS would be designated as a mandatory public mission, with the Department of Local Administration (DLA) collaborating to support EMS implementation across all levels of local government. Additionally, the National Institute for Emergency Medicine (NIEM) would provide technical expertise while the Ministry of Public Health (MOPH) ensures full coverage through high-level emergency units in each zone. The transitional phase would involve targeted measures across national, provincial, and local levels. Nationally, the DLA would establish performance indicators and NIEM would focus on training personnel, while provincially, Provincial Administration Organizations (PAOs) would aid health centers in setting up both basic and advanced EMS units, with district-level MPH units acting as central hubs. Locally, small local administrations would be encouraged to expedite the formation of EMS units. EMS unit distribution in each zone would consider response times, distances, and population density, ensuring a minimum of one advanced unit and two basic units per zone. Finally, preventive strategies would be developed by analyzing the causes of high out-of-hospital mortality rates due to emergency illnesses with high incidence rates, and develop strategies for preventing emergency illnesses.