measure of the response time. The third is that this analysis
examines not only the relationship between response time and
mortality but also the effect of the illness condition for nonmortality
cases. The fourth is that the number of observations in
this study is more than a million compared with hundreds or
thousands in the articles mentioned above. The fifth is that this
analysis does not stop at the outcome of the patient, but instead
takes on an economic perspective, in which the purpose is to find
a monetary value for the total benefits of reducing the response
time. No similar cost-benefit study has been found, and there
have been very few economic studies of out-of-hospital emergency
care [15].
To find the monetary value of the time factor for emergency
responses in Thailand, the analysis was done using an estimation
procedure involving two major steps. The first step was to
analyze the emergency response data in Thailand using logistic
regressions. The dependent variables are fatality, severe injury,
and slight injury. The independent variable is the response time
or the operational time, where response time is the time from
when a call is received until the response team arrives at the
emergency scene and operational time is the time from when a
call is received until the patient is admitted to a hospital. Holding
other independent variables and risk factors constant, the marginal
effect describes the increase or decrease in the time factor
for a 1-minute change and how this will affect the risk of fatality,
severe injury, and slight injury. In the second step, the perceived
marginal effects from the first step are multiplied with monetary
values of fatality, severe injury, and slight injury. Extrapolated to
a loss value for the whole of Thailand, the value would be 2.2
billion Thai baht for response time and 1.1 billion Thai baht for
operational time. These figures represent the positive welfare
effect, for 1 year, of reducing the emergency response time in
Thailand by 1 minute on average.
The second section describes the Thai emergency system and
the data used. The model and the results are presented in the
third section and the fourth section, respectively. The last section
concludes the study with a discussion.