Abstract
This research explores the possibility of establishing an advanced life support unit
(ALS) in the provincial administrative organizations (PAOs) that are now responsible for
running the subdistrict health promotion hospitals. The goals are two-fold. First, this research
seeks to analyze the managerial capacities of three (3) provincial administrative organizations
(PAOs) with the devolved primary care service functions: Rayong, Chiang Mai, and Songkla
provincial administrative organizations. Second, policy recommendations are formulated to
guide these three (3) provincial administrative organizations in preparing for initiating the
emergency medical services. In-depth interviews with relevant government officials, focus
group discussions with stakeholders, and a survey of citizen representatives’ emergency
medical literacy were conducted in the three (3) provinces.
The findings demonstrate that not only does establishing an advanced life support
unit (ALS) in these three (3) provincial administrative organizations align with the demographic
and epidemiological transitions, it also provides opportunities for the devolved subdistrict
health promotion hospitals to integrate the existing primary care services and other longterm care programs with emergency medical services. Such integration will revolutionize and
enable Thailand’s primary care system to deal with population aging and other health related issues. However, the personnel-related laws and regulations must be improved to
allow the provincial administrative organizations to fully engage in the emergency medical
service system. Similarly, the National Institute for Emergency Medicine, Department of Local
Administration, and the Office of the Decentralization Commission need to adopt proactive
measures in preparing the provincial administrative organizations for this new and challenging
public service responsibility
