Developing a Model for the Establishment of Pre-Hospital Emergency Medicine Bases in the Northern Provinces of Iran

Azadeh Ahmadi Dashtiyan, Iravan Masoudi Asl, Leila Riahi, Mahmood Mahmoodi



BACKGROUND: The faster and more accurately Pre-Hospital Emergency Medicine as the first line of care and treatment is done, the less the mortality and disability rates are.

AIM: The present study is an attempt to design a model for the establishment of pre-hospital emergency bases in the northern provinces of Iran.

METHODS: This quantitative-qualitative (mixed-method) research was conducted in two parts: First, using the literature review, interviews with experts in the field, and a comparative study, the most important factors affecting the establishment were extracted. Second, the obtained data were employed to formulate the development model and to design the questionnaire. The required data for factor analysis were collected through a questionnaire distributed among 200 operational personnel in January 2018. The results were analyzed using confirmatory factor analysis and multiple regression.

RESULTS: Five components were identified after the exploratory factor analysis and Varimax with an eigenvalue larger than 1. The effect coefficients calculated for human resources components, service speed, and information and communication system were 0.935, 0.765 and 0.752, respectively. The obtained goodness of fit was very close to one, indicating the one-dimensional strength of the model. The highest parameter estimation in this model was allocated to the human component as 0.935, which has a significant correlation with other components.

CONCLUSIONS: In order to reduce the response time, more attention should be paid to the allocation of budget and organizational roles, education, participation from government departments, establishment of an independent medical emergency organization, and appropriate accessibility to reduce the rates of mortality and morbidity.


Pre-Hospital Emergency Medicine; Iran; Development model

Full Text



  • Bahrami MA, Ranjbar Ezzatabadi M, Maleki A, et al. A Survey on the Yazd Pre-hospital Emergency Medical Services’ Performance Assessment, 2009-2010. Tolooe Behdasht 2011; 9: 45-58
  • Iranian Census Center. Available at: (last accessed August 2012)
  • Bahadori M. Prioritization of pre-hospital emergency service determinants influencing preparedness of Iranian. Iranian Journal of Critical Care Nursing 2011; 4: 73-8
  • Rafiee HR. Investigating the tasks and responsibilities of organizations involved in the education of Iran’s traffic safety culture. Traffic Management Studies 2011; 24: 25-48
  • Siddiqui AA, Zafar H, Bashir SH. An audit of head trauma care and mortality. J Coll Physicians Surg Pak. 2004Mar;14(3):173-7
  • Hunyadi-Anticevic S. EMS system in Croatia. Resuscitation 2006; 68: 185-91;
  • Hajinabi K, Riahi L, Gholipour Varki H. The Relationship between Prehospital Time Indices and on-Scene Death Rate in Traffic Accidents in the 22 Regions of Tehran. Health Information Management 2014; 11: 353-61
  • Al-Shaqsi S. Models of International Emergency Medical Service (EMS) Systems. OMJ 2010; 25: 320-3;
  • Bairami R, Ebrahimipoor H, Rezazadeh A. Preschool hospitals of Mashhad (Qualitative study). Hospital›s profile. International Journal of Pediatric 2017; 16: 81-8
  • Roessler M, Zuzan O. EMS systems in Germany. Resuscitation 2006; 68: 45-9;
  • Hisamuddin N, Hamzah MS, Holliman CJ. Prehospital emergency medical services in Malaysia. J Emerg Med 2007; 32: 415-21;
  • Mohammadi JA, Tabibi SJ. Riahi L, et al. Financing approach in pre-hospital and hospital emergencies in Iran. Quarterly Journal of Healthcare Management 2017; 8: 67-81
  • Pakhere E, Razaeirad M, Tahmasebi B, et al. Ranking the Factors Affecting Readiness of Prehospital Emergency Care According to the Perspectives of Staff in Mazandaran Prehospital Emergency Services. Journal of Mazandaran University of Medical Sciences 2016; 25:261-9
  • VanRooyen MJ, Thomas TL, Clem KJ. International emergency medical services: assessment of developing prehospital systems abroad. J Emerg Med 1999; 17: 691-6;
  • Khankeh H, Alinia S, Masoumi G, et al. Prehospital services by focus on road traffic accidents: Assessment developed and developing countries. JHPM 2013; 2: 71-9
  • Bidgoli HH, Bogg L, Hasselberg M. Pre-hospital trauma care resources for road traffic injuries in a middle-income country a province based study on need and access in Iran. Injury 2011; 42: 879-84;
  • Sharifani M, Tabibi, SJ. A comparative study of the emergency system in selected countries and providing a suitable model for Iran. Quarterly Journal of Healthcare Management 2000; 3: 145-75
  • Eri M, Jafari N, Kabir MJ, et al. Concept and Challenges of Delivering Preventive and Care Services in Prehospital Emergency Medical Service: A Qualitative Study. J Mazandaran Univ Med Sci 2015; 25: 42-57
  • Nasiripour A, Bahadori M, Tofighi SH, et al. Prehospital Emergency Performance in Iran. Critical care Nursing Journal 2008: 2: 139-43
  • Moghadasi H, Rabiei R, Mustafa Z. Pre-hospital Emergency Information System in America and England: a review. Payesh 2014; 13: 383-391
  • Adnet F, Lapostolle F. International EMS systems: France. Resuscitation 2004; 63: 7-9;
  • Walderhaug S, Meland PH, Mikalsen M, et al. Evacuation support system for improved medical documentation and information flow in the field. International Journal of Medical Informatics 2007; 77: 137-51;
  • Weninger P, Hertza H, Mauritz W. International EMS. Austria. Resuscitation 2005; 65: 249-54;
  • Husum H, Gilbert M, Wisborg T. Training pre-hospital trauma care in low-income countries: the ‘Village University’ experience. Medical Teacher 2003; 25: 142-8,
  • Symons P, Shuster M. International EMS Systems: Canada. Resuscitation 2004; 63: 119-22;
  • Ali J, Adam RU, Gana TJ, et al. Impact of the prehospital trauma life support programme in Trinidad and Tobago. West Indian Med J 1998; 47: 102-4


Abstract: 624 views
HTML: 320 views
PDF: 314 views


  • There are currently no refbacks.