The Outcome of Emergency Patient Transported by Public Air Ambulance Service in Thailand

Abstract

Background: There are insufficiency and less accessibility of public emergency medical service (EMS) among emergency patients in remote area of Thailand. Thai sky doctor service, which was initiated by National Institute for Emergency Medicine (NIEM), improved accessibility of emergency patients in urgent need to transfer by aeromedical service in rural and remote area of Thailand. However, there were lack of study about provision of this service in Thailand.  The objectives of this study were to study characteristic and outcome of public air ambulance service (Thai sky doctor service) in Thailand.

Methods: A descriptive cross sectional study was conducted to investigate the outcome of transported emergency patient by Public air ambulance service (Thai sky doctor service) in Thailand. The purposive selection of data was used; and the secondary data of all patients was obtained from NIEM (N= 205). Additional interview data obtained from staff who worked with Thai sky doctor service system. These were national 1669 dispatch center (n=3), regional 1669 dispatch center (n=1), flight medical director (n=3), flight medical team (N=6). Percentage, mean, median, standard deviation were used for descriptive data; and Fisher’s Exact test was used to analyze the factors associated with 1 day and 3 days outcome.

Results: Two hundred and five missions were requested for pubic air ambulance service in Thailand. 184 cases were transported; and 33 cases were not transported due to lack of aircraft, weather condition and patients was dead before being transported. There were identifiable characteristics of Thai sky doctor service and factors associated with 1 and 3 days outcome post air transportation. Gender, age, disease group, patient severity, medical team, response time and transport time were not associated with 1day outcome.  Gender, age, disease group, medical team, response time and transport time were not associated with 3 days outcome. Patient severity was significant difference associated with 3 days outcome at the .05 statistical level (p = .033). There were facilitating and obstacle factors of this service.

Conclusion: Thailand has public air ambulance service policy with good public concern. Patient severity before air transport was associated with delayed 3 days outcome. Further study, there is a need to improve patient outcome and support public air ambulance service development.