PREHOSPITAL EMERGENCY MEDICAL SERVICES UTILIZATION FOR CRITICAL PATIENTS AND ITS DETERMINANTS IN THAILAND

Abstract

This research aimed to determine the situations and factors associated with prehospital emergency medical services (EMS) utilization for critical patients in Thailand. This cross-sectional study used the data of a survey conducted by the Information Technology for Emergency Medical System (ITEMS) of the National Institute of Emergency Medicine, Thailand. The survey collected the data among 1,145 participants using a structured questionnaire. The generalized linear mixed model (GLMM) was used to identify the factors associated with prehospital EMS utilization among critical patients when controlling the effects of covariates presenting adjusted OR and 95% confidence interval. Among 1,145 critical patients, 33.71 % reported using the prehospital EMS of the emergency medical system. Factors that were associated with prehospital EMS use had a high level of knowledge on prehospital EMS (adj. OR = 6.49; 95%CI: 3.78-11.12), high level of trust in quality and safety of prehospital EMS (adj. OR = 4.72; 95%CI: 3.50-6.36), low-moderate severity of perceived illness (adj. OR= 3.71; 95%CI: 2.54-5.42), critical condition occurred at workplace/building (adj. OR=3.57; 95%CI: 2.33-5.47), at home/residential building (adj. OR = 2.21; 95%CI: 1.37-3.58), had adequate services in the area (adj. OR= 1.94; 95%CI: 1.45-2.60), finished at least secondary school (adj. OR= 1.62; 95%CI: 1.11-2.37), less than 15km distance between scene and EMS service site (adj. OR= 1.47; 95%CI: 1.10-1.98), and were very satisfied with services (adj. OR = 1.15; 95%CI: 1.08-1.22) from the reasons mentioned.