Thailand's Emergency Medical System Faces Major Gaps as 2,574 Subdistricts Lack Units

Thailand's emergency medical system is facing significant coverage gaps, with 2,574 subdistricts lacking adequate standard emergency medical units, according to a recent review by a Senate working group. The group is advocating for expanded local coverage and an increase in the number of paramedics. Dr. Premsak Piayura, chairman of the working group studying reforms to crisis management and emergency medical services through digital technology, revealed the findings on September 13. The review highlighted major deficiencies in coverage, staffing, and emergency response units, particularly in thousands of subdistricts where residents lack access to standard emergency medical services. Fiscal 2025 data indicates that 4,861 subdistricts (65.38%) have standard medical response units, while 2,574 subdistricts (34.62%) do not have sufficient units. Regionally, the Northeast boasts the highest coverage at 75.06%, followed by the North (71.70%) and the South (67.68%). The Central region lags behind with only 46.62% coverage. Among provinces, Phuket achieves 100% coverage, followed by Lamphun (98.04%) and Satun (94.44%). Conversely, provinces like Samut Songkhram (27.78%), Phra Nakhon Si Ayutthaya (29.67%), and Ang Thong (34.25%) show critically low coverage rates. Advanced medical response units are scarce, averaging just 1.76 units per 100,000 people, falling below the reference level used in the study. Only 39 provinces meet the benchmark of having at least two standard advanced units per 100,000 population. The Thai emergency medical system, initiated via the 1669 hotline and digital channels, involves triage, dispatch, on-scene treatment, and hospital transfer. The National Digital Emergency Medical Services Platform (NDEMS) and RNIS emergency call and dispatch system aim to enhance information flow and response capabilities during crises and disasters. Currently, Thailand has 92 emergency medical command units and 5,521 approved medical response units, including 4,372 basic, 1,102 advanced, and 102 specialist units. The system employs 7,449 professional medical personnel, including 1,798 emergency physicians and 3,779 emergency nurse practitioners, but only 1,790 paramedics. Over 135,353 support personnel, including 111,605 volunteers, also contribute to the system. Thailand has 9,841 EMS vehicles, comprising 9,641 patient transport vehicles and 200 support vehicles. Key obstacles identified include coverage gaps, a shortage of advanced response units, a critical lack of personnel—especially paramedics—and limited specialist units for critical conditions such as stroke, cardiac emergencies, and serious trauma. The working group has proposed supporting capable local administrative organizations in establishing their own response units, increasing investment and staffing, identifying uncovered areas, and upgrading basic units to advanced levels. A significant plan involves accelerating paramedic training through a "Paramedic Sandbox" project, aiming to increase the paramedic workforce from the current 1,790 to 7,500 within five years. The proposals will be submitted to higher Senate committees for further consideration. Information source: Khaosod English