Challenges to Use Response Time Standard in Assessing Emergency Medical Services in Iran: A Systematic Review

Authors

1 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences,

2 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences

3 1Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, 2Department of Health in Disaster and Emergency, School of Health Safety and Environment, Shahid Beheshti University of Medical Sciences

4 Antimicrobial Resistance Research Center, Rasoul-e-Akram Hospital, Department of Bio-Statistics, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran

10.4103/atr.atr_29_17

Abstract

Response time (RT) accounts as a common tool for emergency medical services (EMS) assessment. While the national standard RT has been
established in Iran since 2007, its application has hardly been put into scrutiny. This study aimed at investigating the use of RT standard in
assessing EMS in Iran. This systematic review included papers focusing on prehospital EMS assessment published in Google Scholar, Scopus,
Embase, PubMed, and the Persian databases of Magiran and SID. Selection criteria involved all English and Persian studies focusing on RT
as an assessment of prehospital EMS in the context of Iran. Repetitious papers and those presented in conferences were omitted, which left
21 papers published from 2007 to mid‑2016 for systematic review. A data collection form was designed. This provided both inclusive information
about the papers and indicators used to report RT in each paper (i.e., mean and percentages of RT below 8 min) as well as the use of these
indicators vis‑a‑vis that of the standard. From among the 21 papers focusing on RT, seven (33%) reported RT as percentages of operations
performed in the means of RT; nine studies compared mean and the national standard as expressed in percentage. Limited use of the national standard to
report RT was identified as a challenge to EMS assessment. Further, the inconsistency that exists when comparing RT in terms of means and
percentage is a challenge to the validity of judgments expressed in some previous studies. Employment of uniform methods to report and
evaluate performance based on the national standard will lead to greater transparency in emergency operation performance.

Keywords

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History

  • Receive Date: 20 May 2017
  • Accept Date: 20 May 2017

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