Prevalence and Associated Factors of Online Medical Direction in Emergency Medical Services at Sawanpracharak Hospital, Nakhonsawan
Keywords:
Online Medical Direction, Emergency Medical Services, National Early Warning ScoreAbstract
Objectives: To determine the prevalence of online medical direction (OLMD) in emergency medical services (EMS). and identify factors associated with OLMD in EMS.
Methods: This cross-sectional analytical study examined all critical patients who received EMS at Sawanpracharak Hospital between June 1, 2024, and June 1, 2025. A total of 1,095 patients were included. Descriptive statistics were used to describe the prevalence. Factors related to OLMD were analyzed using independent t-tests, chi-square tests, or Fisher's exact tests. Multivariable logistic regression was used to determine factors associated with OLMD, with statistical significance set at p-value< 0.05.
Results: Of the 1,095 patients, 291 (26.6%) received OLMD. Patients with respiratory distress were 1.65 times more likely to receive OLMD than those without (p = 0.003, aOR = 1.65, 95%CI: 1.19 - 2.30) An on-scene NEWS of 7 or more resulted in a 51% reduction in the chance of a patient receiving OLMD (p = 0.012, aOR = 0.49, 95%CI: 0.28 - 0.85). A distance of more than 10 km from the hospital was associated with a 1.54-fold increase in the likelihood of receiving OLMD (p = 0.013, aOR = 1.54, 95%CI: 1.10 - 2.15). Patients with an on-scene time greater than 10 minutes were 5.53 times more likely to receive OLMD (p < 0.001, aOR = 5.53, 95%CI: 3.84 - 7.97).
Conclusion: The prevalence of OLMD use in EMS is approximately one-fourth. Significant factors associated with OLMD included respiratory distress, an on-scene NEWS of 7 or more, distance from the hospital to the scene greater than 10 kilometers, and on-scene time exceeding 10 minutes.
Keywords: Online Medical Direction, Emergency Medical Services, National Early Warning Score
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