Effects of the institutional structure and legislative framework on ambulance accidents in developing emergency medical services systems

Abstract

ObjectiveTurkey is a developing country undergoing a system change in the prehospital emergency medical services (EMS). The purpose of this study was to evaluate the effects of the institutional structure and legislative framework on the number of ambulance accidents in Turkey.MethodsDuring the first phase of the study, ambulance accident data was requested and obtained from the Ministry of the Interior. Similarly, data on ambulance numbers were requested and obtained from the Ministry of Health through the Right to Information law. During the second phase of the study, a survey consisting of 112 EMS personnel viewpoints about the effects of the institutional structure and legislative framework on ambulance accidents was conducted using a structured questionnaire. A total of 209 EMS personnel completed the survey.ResultsThe number of ambulance accidents increased by 42.5% over the last five years, whereas the area of coverage increased by 57.3% during the same period. The rate of EMS personnel experiencing ambulance accidents was 69.4%. When age, sex, and profession variables were considered, the varying profiles of the ambulance operators were found to have no significant effect on the number of ambulance accidents following the system change.ConclusionThe rise in the number of ambulance accidents in Turkey was not significant when compared with the increase in the area of responsibility. The present system change was also found to have no effect on the number of accidents. On the other hand, problematic areas in the institutional structure and the legislative framework increased the risk of accidents.

The risk factors Finnish paramedics recognize when performing emergency response driving

“…Annually, multiple severe traffic accidents involving ambulances are observed throughout the world (Custalow and Graviz, 2004;De Graeve et al, 2003;Eksi et al, 2015;Kahn et al, 2001;LaDuke et al, 1999;Sanddal et al, 2010;Suserud and Jonsson, 2013;Yardley and Donaldson, 2016). These events represent remarkable risks to patients, workers, and members of the public.…”

“…Paramedics face many risks for crashes and injury events (Custalow and Graviz, 2004;De Graeve et al, 2003;Eksi et al, 2015;Kahn et al, 2001;LaDuke et al, 1999;Sanddal et al, 2010;Suserud and Jonsson, 2013;Yardley and Donaldson, 2016). According to a previous register-based study using ambulance crash data by Jörgen (2007), the majority of the crashes involving an ambulance in northern Finland occur during daylight hours in urban areas under icy and snowy weather conditions.…”

Factors associated with the occurrence of prehospital medical interventions provided by physicians among non-trauma patients: a single-centre retrospective observational study in Japan

“…These findings may suggest that the dispatch criteria should be based on whether a patient needs prehospital medical interventions during transportation rather than on whether a patient needs a physician to reach them earlier. Prehospital systems focusing intently on delivering medical resources earlier might have some adverse effects, including misjudgments resulting in physicians being dispatched to less severe patients when there are multiple alarms, pressure on drivers to reach the scene earlier potentially increasing the risk of automobile accidents18 and cost problems.…”

Traffic safety knowledge gain of ambulance drivers after simulator-based training

“…Accidents occur most often at junctions, usually at a red light, and during overtaking situations [ 1 – 4 , 8 , 9 ]. Accident statistics show that high speeds and tailgating are high risk factors for severe traffic accidents both for ambulances and in general [ 10 , 11 ]. Despite these data, a survey in the US showed that some ambulance drivers believe 75 miles per hour (~ 120 km/h) to be a reasonable speed when responding to emergencies [ 12 ].…”

“…Ambulance drivers have more driving experience than do average drivers in Germany [ 13 ]. More experience, however, does not necessarily lead to more knowledge [ 10 , 30 ]. As all these studies show complex relationships and many influencing factors between knowledge, knowledge transfer and behavior, accurate measurement of knowledge in training evaluations is crucial.…”