Thematic analysis of six Asian prehospital emergency medical systems to explore development principles

Abstract

Background: Well-designed and functioning emergency medical service (EMS) can provide equitable access to emergency care to improve health issues, especially in low- and middle-income countries where the majority of deaths are due to conditions that could be treated with emergency care. To address this gap, this study explored the contextually appropriate development process in addition to the system architecture, which is lacking in Global South EMS research.

Method: This study was a thematic analysis of the development of EMS systems in six Asian countries. Experts in emergency care were selected through convenience sampling. Each country described and evaluated its EMS system using a standardized form with 102 EMS items that cover the emergency care system in terms of leadership, governance, financing, community-based activities, prehospital care, and quality assessment. From the descriptions, various themes were extracted focusing on the developmental perspective of EMS in Asia.

Result: The study identified the domain of the developmental focus, best practices, and future strategies for EMS in the Asian region. The identified areas for developmental focus are governance, multidisciplinary collaboration, communication/coordination, community participation, decentralization, equitable access, supply-demand balance, and quality assurance activities.

Conclusion: Countries under investigation achieved progress in planning, implementing, and sustaining EMS through varied strategies in the mentioned focal areas that can be emulated by other countries in this region. Further, their development levels varied according to the extent to which each country realized the development principles identified in this study.

Conflict of interest statement

The authors declare no conflict of interest.

Author contributions

All authors contributed to data collection, analysis, and interpretation. Ratnayake A, Bagaria D, and Nakahara S drafted the main text; all authors contributed to the descriptions of each country. All authors approved the final version.

Funding

This study was supported by the Japan Society for the Promotion of Science KAKENHI (19 K09403); the funding body did not play any role in the study or preparation of the manuscript.

Ethical approval of studies and informed consent

Not applicable.

Acknowledgments

None.

Presentation

This work was presented at the 6^th World Trauma Congress held in Tokyo from August 9-12, 2023.

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