Investigating the relationship between the technical quality of pre-hospital emergency services with providers' characteristics and health outcomes

Abstract

Abstract Introduction: Pre-hospital emergency is one of the main components of the health system. Different countries use different models of this system depending on their conditions. Improving the quality of pre-hospital emergency services can cause positive health outcomes in patients and prevent injuries and deaths. Materials and Methods: The present study is a qualitative-quantitative study that evaluates the technical quality of pre-hospital emergency services in the first six months of 2018 through matching standard treatment protocols with treatment interventions performed by operational experts. For this purpose, 377 patients with three diseases of acute respiratory failure, acute cardiac syndrome, and stroke were studied. Also, the relationship between the providers' characteristics, including educational qualifications, experience and hours of specialized training, with the technical quality of services was also examined, and at the end, through interviews with 18 experts and managers of pre-hospital emergency rooms, the challenges and obstacles to the implementation of treatment protocols in pre-hospital emergency rooms were identified. Findings: Compliance with the protocol in the three groups of patients under study is 54.9% for acute respiratory failure patients, 65.6% for acute cardiac syndrome patients centered on myocardial infarction, and 63.7% for stroke patients. In patients with acute cardiac syndrome, there is a significant difference between service history and educational qualification with the technical quality of services. In other disease groups, no significant difference was observed between the characteristics of providers and the technical quality of services. The technical quality of services in two groups of patients has a significant relationship with health outcomes. Challenges and obstacles to the implementation of protocols were also identified in 7 main components and 34 sub-components. Conclusion: The low technical quality of pre-hospital services is caused by various factors, which certainly affects the health outcomes of patients based on existing studies and can cause an increase in the amount of injury and death in these patients. Developing appropriate programs in order to remove the existing obstacles is necessary and necessary. Keywords: pre-hospital emergency, technical quality, health outcomes