Comparison of emergency medical services systems across Pan-Asian countries: A web-based survey

Sang Do Shin, Marcus Eng Hock Ong, Hideharu Tanaka, Matthew Huei Ming Ma, Tatsuya Nishiuchi, Omer Alsakaf, Sarah Abdul Karim, Nalinas Khunkhlai, Chih Hao Lin, Kyoung Jun Song, Hyun Wook Ryoo, Hyun Ho Ryu, Lai Peng Tham, David C. Cone

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54 Citations (Scopus)

Abstract

Background. There are great variations in out-of-hospital cardiac arrest (OHCA) survival outcomes among different countries and different emergency medical services (EMS) systems. The impact of different systems and their contribution to enhanced survival are poorly understood. This paper compares the EMS systems of several Asian sites making up the Pan-Asian Resuscitation Outcomes Study (PAROS) network. Some preliminary cardiac arrest outcomes are also reported. Methods. This is a cross-sectional descriptive survey study addressing population demographics, service levels, provider characteristics, system operations, budget and finance, medical direction (leadership), and oversight. Results. Most of the systems are single-tiered. Fire-based EMS systems are predominant. Bangkok and Kuala Lumpur have hospital-based systems. Service level is relatively low, from basic to intermediate in most of the communities. Korea, Japan, Singapore, and Bangkok have intermediate emergency medical technician (EMT) service levels, while Taiwan and Dubai have paramedic service levels. Medical direction and oversight have not been systemically established, except in some communities. Systems are mostly dependent on public funding. We found variations in available resources in terms of ambulances and providers. The number of ambulances is 0.3 to 3.2 per 100,000 population, and most ambulances are basic life support (BLS) vehicles. The number of human resources ranges from 4.0 per 100,000 population in Singapore to 55.7 per 100,000 population in Taipei. Average response times vary between 5.1 minutes (Tainan) and 22.5 minutes (Kuala Lumpur). Conclusion. We found substantial variation in 11 communities across the PAROS EMS systems. This study will provide the foundation for understanding subsequent studies arising from the PAROS effort.

Original languageEnglish
Pages (from-to)477-496
Number of pages20
JournalPrehospital Emergency Care
Volume16
Issue number4
DOIs
Publication statusPublished - 2012 Oct 1

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All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency

Cite this

Shin, S. D., Hock Ong, M. E., Tanaka, H., Ma, M. H. M., Nishiuchi, T., Alsakaf, O., Abdul Karim, S., Khunkhlai, N., Lin, C. H., Song, K. J., Ryoo, H. W., Ryu, H. H., Tham, L. P., & Cone, D. C. (2012). Comparison of emergency medical services systems across Pan-Asian countries: A web-based survey. Prehospital Emergency Care, 16(4), 477-496. https://doi.org/10.3109/10903127.2012.695433