• TH
    • EN
    • Register
    • Login
    • Forgot Password
    • Help
    • Contact
  • Register
  • Login
  • Forgot Password
  • Help
  • Contact
  • EN 
    • TH
    • EN
View Item 
  •   Home
  • สถาบันวิจัยระบบสาธารณสุข (สวรส.) - Health Systems Research Institute (HSRI)
  • Research Reports
  • View Item
  •   Home
  • สถาบันวิจัยระบบสาธารณสุข (สวรส.) - Health Systems Research Institute (HSRI)
  • Research Reports
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Evaluating Pre-hospital Emergency Care Services in the Context of Decentralization Policy

สัมฤทธิ์ ศรีธำรงสวัสดิ์; Samrit Srithamrongsawats; ไพบูลย์ สุริยะวงศ์ไพศาล; Paiboon Suriyawongpaisarn; พงศกร อธิกเศวตพฤทธิ์; Pongsakorn Atiksawedparit; ภาณุวิชญ์ แก้วกำจรชัย; Phanuwich Kaewkamjonchai; พีรสิชฌ์ สิทธิรัตน์; Peerasit Sitthirat; ปวินท์ ศรีวิเชียร; Pawin Sriwichian; มนสิชา หวังพิพัฒน์วงศ์; Monsicha Wangpipatwong; พิวัฒน์ ศุภวิทยา; Piwat Suppawittaya; พีรภาส สุขกระสานติ; Peerapass Sukkrasanti; จิณณ์ รัชโน; Jin Rushchano; แคเรน เอ็ม ทัม; Karen M Tam;
Date: 2567-09
Abstract
Since 2016, Thailand has initiated the decentralization of its emergency medical services (EMS) system, transferring emergency medical dispatch centers from hospitals to provincial administrative organizations (PAOs) to better serve local populations. Currently, 15 provinces have successfully transferred these centers. This study uses a concurrent mixed-methods research design, combining quantitative analysis of secondary data from the Information Technology for Emergency Medical Systems (ITEMS) database and patient surveys, with qualitative studies involving in-depth interviews and focus group discussions with central policymakers and local practitioners. Key findings 1. Performance Comparison: 1.1 Provinces with transferred dispatch centers show lower performance in telephone triage accuracy, use of high-level emergency response units, and response times. However, there is no difference in out-of-hospital cardiac arrest mortality between transferred and non-transferred provinces. 1.2 Access to EMS has increased in transferred provinces, but the usage rate of the 1669 emergency hotline is lower in these provinces compared to non-transferred ones, though still higher than the national average. Critical emergency patients prefer going to hospitals directly due to convenience. 2. Systemic Evolution: 2.1 Coverage Expansion: Limited due to local readiness and willingness, with no plan for decentralizing EMS to local organizations. 2.2 Quality Standards: NIEMS focuses on setting standards, but lacks sufficient support for local areas, particularly in budget and training. 2.3 Digital Information System: Significant gaps in implementing D1669, including lack of readiness assessments and insufficient support. The new ITEMS4.0 system has reduced data integrity compared to ITEMS3.0. 2.4 Budget and Compensation: Decreased budgets for NIEMS, inadequate compensation rates for emergency services, and financial strain on hospitals. 2.5 Human Resource Management: Contractual employment hinders capacity building and retention. 2.6 Health System Science: Crucial for networked operations, including leadership, systemic thinking, and change management. 3. Bangkok's EMS Gap: 3.1 The main issue in Bangkok is finding hospitals to receive critical emergency patients, differing from other provinces where coverage and quality standards are the primary concerns.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
Fulltext
Thumbnail
Name: hs3184.pdf
Size: 21.78Mb
Format: PDF
Download

User Manual
(* In case of download problems)

Total downloads:
Today: 0
This month: 2
This budget year: 52
This year: 26
All: 52
 

 
 


 
 
Show full item record
Collections
  • Research Reports [2471]

    งานวิจัย


DSpace software copyright © 2002-2016  DuraSpace
Privacy Policy | Contact Us | Send Feedback
Theme by 
Atmire NV
 

 

Browse

HSRI Knowledge BankDashboardCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjectsSubjectsการบริการสุขภาพ (Health Service Delivery) [619]กำลังคนด้านสุขภาพ (Health Workforce) [99]ระบบสารสนเทศด้านสุขภาพ (Health Information Systems) [286]ผลิตภัณฑ์ วัคซีน และเทคโนโลยีทางการแพทย์ (Medical Products, Vaccines and Technologies) [125]ระบบการเงินการคลังด้านสุขภาพ (Health Systems Financing) [159]ภาวะผู้นำและการอภิบาล (Leadership and Governance) [1283]ปัจจัยสังคมกำหนดสุขภาพ (Social Determinants of Health: SDH) [228]วิจัยระบบสุขภาพ (Health System Research) [28]ระบบวิจัยสุขภาพ (Health Research System) [20]

DSpace software copyright © 2002-2016  DuraSpace
Privacy Policy | Contact Us | Send Feedback
Theme by 
Atmire NV