Introduction
It is reasonable to say that all efforts should be made to decrease
the time factor in the emergency alarm chain from calling to
taking the call, to dispatching, to getting ready to leave, to driving
to the injured people or people involved in the accident, to taking
care of the injured or suppressing the fire, and to getting the
injured to the hospital. However, should all efforts be made solely
to decrease the time factor? Such efforts are costly, and there are
other health matters that investments could be done in: better
ambulances with more technical equipment, more training of the
staff, better hospitals, provision of self-help equipment, and so
forth. An economical way of dealing with this problem of the
public sector is to perform cost-benefit analyses. The cost side of
such an analysis is quite unproblematic. It consists of costs for
new equipment, staff education, and so forth. The benefit side,
however, is more problematic. For example, if the emergency
sector intends to invest in a new alarm technology that could
save 1 minute in response time for all responses, how much will
such an investment lead to in benefits measured in economic
welfare terms? Not only must the effect of a changed response
time, measured in fewer fatalities, injuries, and illness, be found,
but this change should also be measured in monetary units.
The purpose of this study was to find a monetary value for the
time factor of emergency responses in Thailand. It is not a costbenefit
analysis because it considers only the benefit side of the
time factor. Notwithstanding, the results of the study could be
used in a cost-benefit analysis. Furthermore, the methodology
could be used for ambulance services elsewhere.
As noted by Blanchard et al. [1], there are not so many studies
on the relationship between the response time of emergency
medical service and the saving of lives. The results have been
mixed. When it comes to cardiac arrest, reducing ambulance
response time has been shown to increase the survival rate [2–4].
Gonzales et al. [5] found increased emergency medical service
prehospital time to be associated with higher mortality rates, as
did Wilde [6] and McCoy et al. [7] recently. Fire and rescue
services have been found to increase the survival rate when
having shorter response times than traditional ambulances for
health care responses [8–10]. Newgard et al. [11], however,
recently concluded that there is no relationship between the
response time and outcome of the patient, as other studies have
also done before [12–14].
There are five motivations behind this article. The first is that,
as noted above, there is not much research done on the effect of
the response time. The second is that most of the studies
mentioned have taken up one health problem (cardiac arrest),
while from a planning perspective there are, of course, many
more reasons for having ambulance services. Furthermore, most
of the analyses have evaluated the 8-minute response time goal
for American advanced life support units responding to lifethreatening
events. This study focuses instead on a continuous