Suriyawongpaisal Paibul, Tansirisithikul Rassamee, Srithamrongsawat Samrit
Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Jan;95(1):111-8.
Emergency medical services (EMS) have been steadily developed in Thailand. However the patient perspective has not been explicitly considered in performance assessment thus far although it is a key consideration for quality improvement in public organizations.
To investigate the Thai patient experience in EMS and emergency departments (ED) and help Thai leaders guide future improvements.
The present study was a survey of selected ED of 14 public hospitals in four geographical regions. Five hundred fifty patients from each hospital were interviewed between June and July 2009. The data were collected by medical records review and face-to-face interview.
Six thousand four hundred forty four patients [average age of 36.01 years (range: 0-98), almost 50% female, 95% local residents] participated in the survey. Ambulances staffed with paramedics or trained volunteers transported 7.28% of the patients. Of those, 80% to 95% were satisfied, rating the service as 'safe'. Volunteer transfers had lower satisfaction scores. Patients spent an average of 63.8 minutes in the ED. Almost all patients were satisfied and would recommend the services to their friends or relatives. The most common factors contributing to dissatisfaction were with waiting time for consultation and pain management.
There is high patient satisfaction with emergency services in public hospitals. Nonetheless, the lower satisfaction for volunteer ambulance service, the concern about waiting time, and pain management highlights opportunity for improvement. The rapid, low-cost patient surveys combined with paper-based medical record review can yield useful information for quality improvements
泰国的紧急医疗服务（EMS）一直在稳步发展。然而，尽管患者视角是公共组织质量改进的关键考虑因素，但迄今为止在绩效评估中尚未明确考虑这一点。
调查泰国患者在紧急医疗服务和急诊科（ED）的体验，并帮助泰国的领导者指导未来的改进。
本研究是对四个地理区域的14家公立医院的选定急诊科进行的一项调查。2009年6月至7月期间，对每家医院的550名患者进行了访谈。数据通过病历审查和面对面访谈收集。
6444名患者[平均年龄36.01岁（范围：0 - 98岁），近50%为女性，95%为当地居民]参与了调查。配备护理人员或经过培训的志愿者的救护车运送了7.28%的患者。其中，80%至95%的患者表示满意，将服务评为“安全”。志愿者转运的满意度得分较低。患者在急诊科平均花费63.8分钟。几乎所有患者都表示满意，并会向朋友或亲属推荐这些服务。导致不满的最常见因素是咨询等待时间和疼痛管理。
公立医院的紧急服务患者满意度较高。尽管如此，志愿者救护车服务满意度较低、对等待时间的担忧以及疼痛管理突出了改进的机会。快速、低成本的患者调查与纸质病历审查相结合，可以为质量改进提供有用信息。
