The Situations of Emergency Medical Services Associated with Elderly Falls in Thailand: Policy Recommendation

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ศรวณีย์ ทนุชิต ดนัย ชินคำ ณัฐธิดา มาลาทอง สุรเดช ดวงทิพย์สิริกุล ศรีเพ็ญ ตันติเวสส

Abstract

Falling in elderly people is a major public health problem with its rate increasing throughout the world. Globally, around 1,000 people in this group die from falls each year, or an average of three people per day. Falls in elderly people result in a lower quality of life due to the disability, the inability to perform daily activities by themselves, and an increase in death rates. Moreover, it results in medical treatment and hospital stays which lead to increasing healthcare expenditures. If elderly people can get access to emergency medical services promptly to receive appropriate treatment, they will be safer with reduced complications and shorter lengths of stay in the hospital. This study aims to develop Emergency Medical Services in cases of after elderly person falls in Thailand. The study was conducted through: 1) literature and document reviews on national and international experiences in emergency medical services for the elderly 2) in-depth interview and focus group discussions with key informants who are involved in emergency medical services systems and 3) stakeholder meetings to consult on Emergency Medical Services Development for elderly falls. As a result, it shows from the literature review that there is no specific Emergency Medical Services program for falling elderly people. However, the priority is given to the appropriateness of technology usage to facilitate elderly persons rescue calls during falls. The in-depth interviews and focus group discussions show that Thailand might not need Emergency Medical Services dedicated specifically for falling elderly people because its current services have generally covered all health issues for everyone. Meanwhile, the important problems are the lack of experienced personnel to provide Emergency Medical Services, with many of them still needing more training in providing care to falling elderly persons. The policy recommendations for Emergency Medical Services development for elderly falls in Thailand include that National Institute for Emergency Medicine (NIEM) and relevant organizations should provide the practical training to the emergency medical personnel in the scope of emergency medicine for falling elderly persons. The National Institute for Emergency Medicine and Ministry of Public Health should also provide financial support for the development of emergency medical services system including human resources development, manpower recruitment, and necessary tools and technologies to enhance services efficiency.

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References

1. Institute for Population and Social Research. Thailandometers [Internet]. 2017 [cited 2017 march10].Availablefrom:https://www.thailandmeters.mahidol.ac.th/ (in Thai).
2. Foundation of thai gerontology research and development institute. Situation of the Thai elderly 2013 [Internet]. 2013 [cited 24 July 2017]. Available from:https://thaitgri.org/?p=
37134 (In Thai).
3. Mortality GBD, Causes of Death C. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388
(10053):1459-544.
4. Kannus P, Palvanen M, Niemi S, Parkkari J. Alarming rise in the number and incidence of fall-induced cervical spine injuries among older adults. J Gerontol A Biol Sci Med Sci. 2007;62(2):180-3.
5. Nipa sichang and vitra kave. [Internet] [cited 2017 May 28]. Available from: https://
thaincd.com/2016/media-detail.php?id=120
95&tid=1-001-003,38&gid=1-027.
6. World Health Organization. WHO global report on falls prevention in older age [Internet] 2008 [cited 2017 May 28]. Availablefrom:https://www.who.int/iris/handle/10665/43811.
7. National institute for emergency medicine. Guidelines to follow the rules, criteria and procedures to sort and prioritize emergency care at the emergency room, according to the Emergency Medical Board. 3rd ed. Nonthaburi. 2015.[Internet] 2013 [cited2017 June 1. Available from: https://www.niems.
go.th/th/Upload/File/255803301523288185_74OCtOGV0971iG5k.pdf (In Thai).
8. Centers for Disease Control and Prevention. Preventing Falls : A Guide to Implementing Effective Community-Based Fall Prevention Programs. Atlanta, Georgia. 2015.
9. American College of Emergency P, American Geriatrics S, Emergency Nurses A, Society for Academic Emergency M, Geriatric Emergency Department Guidelines Task F. Geriatric emergency department guidelines. Ann Emerg Med. 2014;63(5):e7-25.
10. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012(9):CD007146.
11. Queensland Health. Queensland How to Stay On Your Feet® Checklist [online]. Queensland Government; 2014 [cited 1 march 2017]. Availablefrom:https://www.health.qld.gov.au/
__data/assets/pdf_file/0028/429814/33381_full.pdf.
12. Peel N, Bell, RAR., Smith, K. . Queensland Stay On Your Feet® Community Good Practice Guidelines – preventing falls, harm from falls and promoting healthy active ageing in older Queenslanders: Queensland Govern-
ment; 2008.
13. Romli MH, Mackenzie L, Lovarini M, Tan MP. Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls. BMJ Open. 2016;6(8):e012048.
14. Tang A, Chin-Hao O, Ahmad A. Fall Detection Sensor System for the Elderly. International Journal Of Advanced Computer Research. 2015;5(19):176-83.
15. Han H, Ma X, Oyama K. Flexible Detection of Fall Events Using Bidirectional EMG Sensor. Stud Health Technol Inform. 2017;245:1225.
16. Department of Health & Human Services Falls – services for older people.[Internet] [cited 2017 June 18]. Available from: https://
www.betterhealth.vic.gov.au/health/servicesandsupport/falls-services-for-older-people/
17. Suputtitada A, Boonsinsuk R, Suttanon P. Manual for elderly care: falls prevention. Nonthaburi: Health Systems Research Institute; 2016. (In Thai).
18. Foundation of Thai Gerontology Research and Development institute. A fall prevention manual for elderly. Bangkok: Foundation of Thai Gerontology Research and Development institute; 2015 (In Thai).
19. Department of Health ministry of public health. Elderly Health Handbook [Internet]. 2017 [cited 2017 May 24]. Available from: https://eh.anamai.moph.go.th/main.php?filename=Agingmanual (In Thai).
20. Department of Health, Australia W. Falls Prevention Model of Care: Perth: Health Strategy and Networks, Department of Health, Western Australian; 2014.
21. Takeharu S, Kenji I. Project on Information-support Solution in Emergency Medical Service. Journal Fujitsu Scientific & Technical Journal 2015;51(3):39-49.
22. Department of medical services. Guideline for ER service delivery. [Internet] 2018 [cited 2018 September 30]. Available from: https://
www.dms.moph.go.th/dms2559/download/ERServiceDelivery.pdf (In Thai).
23. Strategy and planning division ministry of public health. Key Performance Indicators of Ministry of Public Health’s: fiscal year 2016. [Internet] 2009 [cited 2017 June 15]. Availablefrom:https://bps.moph.go.th/new_bps
/sites/default/files/KPI_2561_edit3_.pdf (In Thai).
24. Inspection division ministry of public health. Audit Report for Fiscal Year 2018. [Internet] 2018 [cited 2017 July 15]. Available from: https://bie.moph.go.th/e-insreport2/reporttk2
_ch.php?nasubject_id=113&id_regroup=2&id_area=1&around=2&id_group=2&year=2561&fbclid=IwARTTkOGLKuKFqhLCDAnl-QTAVFlt_ZQwx_50ae0KQmW4I (In Thai).
25. National institute for emergency medicine. Interfacility Patient Transfer. Nontraburi: National institute for emergency medicine; 2014. (In Thai).
26. Australian Commission on Safety and Quality in Health Care. Falls best practice guidelines. [Internet] 2009 [cited 2017 June 14]. Availablefrom:https://clinicalexcellence.qld.
gov.au/resources/falls-best-practice-guide
lines.
27. Pagaiya N, Phanthunane P, mandviroj S, Suwatmakin A, Kruesathit O, naramethakul P, et al. Estimation of requrement and human resource planing for Emergency Medical Services. Nonthaburi; 2014. (In Thai).
28. Phadoongsit Chumuanborirak.The compentency development model for personnel working in community emergency medical service : a case study in thailand and lao people's democretic republic: loie rajabhat university; 2009.
29. National institute for emergency medicine. a guideline for budget allocation to support the Emergency Medical Services [Internet]. 2017 [cited 24 May 2017]. Available from: https://ebudget.niems.go.th/ebudget/Upload/File/255711201130391506_y7FOoZVtU1GIQrtw.pdf.
30. Pietrzak E, Cotea C, Pullman S. Does smart home technology prevent falls in community-dwelling older adults: a literature review. Inform Prim Care. 2014;21(3):105-12.
31. Cho SJ, Kwon IH, Jeong J. Application of Telemedicine System to Prehospital Medical Control. Health Inform Res. 2015;21(3):
196-200.