Abstract
Background: Acute illness and accidents are the leading cause of death in Thailand. Developing a
good systematic pre-hospital care can help reducing morbidity and mortality. To achieve this goal, the
Ministry of Public health has issued a policy for all hospitals in Thailand to set up an Emergency Medical Service (EMS) system. Nevertheless, this service system is not widely acknowledged in Chiang Mai. Most
of the patients did not use the service and go to the hospital by themselves Objective: To determine reasons
of underuse of Emergency Medical Service in patients visiting the Emergency room, Maharaj Nakorn
Chiang Mai hospital. Methods: This was a prospective observational study by means of questionnaires
filled by the patients or anyone accompanied them to the emergency room, Maharaj Nakorn Chiang Mai
hospital. Only 3 level of triage was used; level 1-Resuscitation, level 2-Emergency, and level 3-Urgency.
This study was conducted during the period from March to October 2011. Analysis was made by dividing
participants into 2 groups; patients coming to the emergency room by themselves, and the ones coming
by using EMS system. Results: There were 102 participants; 64 coming by themselves and 38 using EMS.
There were 44 traumatic patients, and 58 non traumatic patients. 4 participants were of triage level 1
Resuscitation, 42 of triage level 2 Emergency and 56 of triage level 3 Urgency. Sex, degree of education and
occupation were not related to EMS activation. Many reasons accounted for this problem; 64.1% of the
patients had their own vehicles, 50% did not know of the service, and 25% thought that their symptoms
were insufficient to activate EMS system. People in Chiang Mai learned of the EMS system through many
advertising media, in sequentially billboards, television, and radio programs. Conclusion: The reasons of
underuse of EMS system in Chiang Mai were: unknown of existence, failure to recognize the importance,
and doubt in the Emergency Medical Service systems.
