Implementation of a novel communication system for emergency medical services to improve transport in underserved areas of South Korea
Eui‐Jae Kim, Sang‐Chul Kim, So‐Yeon Kong, Young‐Min Kim, Gwan‐Jin Park, Hyun‐Seok Chai, Hoon KimAbstract
Introduction
Ambulance offload delays in South Korea have worsened since the coronavirus disease pandemic, further aggravated by recent healthcare workforce conflicts and hospital capacity shortages. This study aimed to evaluate the implementation of an ICT‐based emergency medical service (ICT‐EMS) system to improve transport coordination and reduce total prehospital delays in medically underserved areas.
Methods
This community‐based intervention study was conducted between 1 November 2023 and 31 October 2024 in North Chungcheong Province, South Korea. The ICT‐EMS system facilitated real‐time communication between 119 emergency medical technicians (EMTs) at 68 fire safety centers and clinicians at 23 Emergency Medical Institutions (EMIs). Our primary outcome was the hospital acceptance rate, defined as the proportion of ICT‐EMS managed patients who were successfully accepted by a receiving hospital. Secondary outcomes included the number of hospital requests per patient, ICT‐EMS response time, hospital designation time, total prehospital time, and reasons for hospital nonacceptance. Descriptive and comparative analyses were performed to assess temporal and regional variations in system performance.
Results
Among 22,451 patients managed using the ICT‐EMS system, 93.8% were successfully admitted following an average of 2.4 hospital requests per patient. The median hospital response and designation times were 1.1 and 2.8 min, respectively, whereas the median total prehospital time was 34.7 min; 91.9% of patients arrived within 60 min. However, regional disparities were observed although the southern region comprised 7% of the provincial population, it accounted for only 0.8% of transports and had the longest delays. Among the 6.2% of patients not accepted, the leading causes of nonacceptance were clinical capacity limitations (66.4%), followed by facility shortages (16.7%) and triage‐related factors (14.2%).
Conclusion
The ICT‐EMS system demonstrated significant potential to streamline emergency medical services operations and enhance hospital coordination, particularly in underserved areas. Expanding such systems nationally could improve equity and timeliness of emergency care delivery.