Response Time and Perspectives of Practitioners in the Emergency Medical Services System Regarding Emergency Response Time of Critically Patients in Thailand

Abstract

This study aimed to assess the relationship between response time and survival rates of critically patients and explore the perspectives of practitioners in the emergency medical services system regarding emergency response times for critically patients. A mixed-methods research design was employed, incorporating quantitative research through a retrospective study of data from the Information Technology for Emergency Medical System (ITEMS) in 2023, and qualitative research using focus group discussions and in-depth interviews with emergency medical practitioners in Chiang Mai, Khon Kaen, Trang, and Bangkok, Thailand, totaling 77 participants. The results indicated that in 2023, the average response time was 10 minutes, with 39% of critical patients receiving emergency services within 8 minutes. An analysis of the relationship between response time and survival revealed that as the response time increased, the risk of mortality for critically patients significantly increased. When examining the relationship between response times and mortality, the response times were categorized into 4 minutes, 8 minutes, 10 minutes, and 15 minutes. It was found that critically emergency patients who received emergency response within 8 minutes had a reduced risk of mortality compared to those with response times exceeding 8 minutes (OR= 0.92, 95%CI = 0.85–0.98). Emergency medical practitioners generally viewed the response time for emergency operations as an important factor influencing the survival chances of emergency patients, particularly in cases of cardiac arrest and accidents. The use of response time for emergency operations as a quality indicator remains essential, as it measures efficiency and demonstrates service standards to the public. Recommendations: (1) set a standard for emergency response time for critically patients at the national level that is consistent with the international standard of 8 minutes, but must focus on solving problems that prevent response within 8 minutes, and (2) consider setting emergency response time at the local level to be consistent with the context of each area, taking into account resource readiness and geography.