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Table 2 Domain-wise sample questions and indicators of EMS framework

From: Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach

No. Domain Sample questions/indicator
1 EMS service delivery • Is the service organized at state level or national level?
• Number of organizations registered for EMS delivery
• Distribution of vehicles
• Basic vs. advance life support services
2 Health workforce • Is there certified training curriculum and licensing mechanism?
• Average experience and turn over in EMS organizations
• EMS crew configuration
• EMS workforce demography (sex and age composition)
3 Information systems • Radio communication, dispatch system
• GPS trackers, location identifiers
• Transfer of information from ambulance to receiving service
4 Medical products • Availability of life-saving medications
• Availability of aspirin, analgesia, oxygen in the vehicle
5 Financing • Proportion of EMS covered by public funds
• Do private insurance companies cover emergency care and EMS?
• Other tax mechanisms to provide for EMS funds
6 Governance • Is there a lead agency?
• What is the legislative framework?
• Are their regulatory bodies for setting and monitoring EMS standards?
7 Access • Availability of Universal access number
• Availability of alternate emergency services
8 Coverage • Proportion of population covered by the ambulance services
• Are there differences in coverage in rural vs. urban areas?
• Proportion of towns or villages covered through EMS services all the time
9 Quality • Use of standardized documentation
• Audits, benchmarks, and indicators to track performance and outcomes, reporting frequency
• Quality improvement initiatives
• Standards for ambulance and crew configuration
10 Safety • Availability of clear guidelines, protocols for assessment, treatment, and transfer; hands-off protocols
• Medical direction
• Working conditions; injury prevention policies and working hours of the ambulance crew
• Enforcement of regulations
11 Improved Health • Trends in pre-hospital survival of select emergency condition for ambulance- transported patients
12 Responsiveness • Responsiveness of EMS services, average response time
13 Risk protection • Availability of emergency care insurance plans through employers or private companies
• Out-of-pocket expenditure for EMS care
14 Improved efficiency • Efficient field triage
• Use of technology and data to improve services such as real-time electronic run sheets