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REVIEW ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 4  |  Page : 55-62

Challenges to Use Response Time Standard in Assessing Emergency Medical Services in Iran: A Systematic Review


1 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
2 Safety Promotion and Injury Prevention Research Center; Department of Health in Disaster and Emergency, School of Health Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Clinical Sciences and Education, Karolinska Institute, Södersjukhuset (KI SÖS), Stockholm, Sweden, IR Iran
3 Antimicrobial Resistance Research Center, Rasoul-e-Akram Hospital, Department of Bio-Statistics, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran

Correspondence Address:
Dr. Mohammadreza Maleki
Department of Health Services Management, Iran University of Medical Sciences, Tehran
IR Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/atr.atr_29_17

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Response time (RT) accounts as a common tool for emergency medical services (EMS) assessment. While the national standard RT has been established in Iran since 2007, its application has hardly been put into scrutiny. This study aimed at investigating the use of RT standard in assessing EMS in Iran. This systematic review included papers focusing on prehospital EMS assessment published in Google Scholar, Scopus, Embase, PubMed, and the Persian databases of Magiran and SID. Selection criteria involved all English and Persian studies focusing on RT as an assessment of prehospital EMS in the context of Iran. Repetitious papers and those presented in conferences were omitted, which left 21 papers published from 2007 to mid-2016 for systematic review. A data collection form was designed. This provided both inclusive information about the papers and indicators used to report RT in each paper (i.e., mean and percentages of RT below 8 min) as well as the use of these indicators vis-a-vis that of the standard. From among the 21 papers focusing on RT, seven (33%) reported RT as percentages of operations performed in <8 min according to the national standard and compared the percentage with the national standard. A total of 18 (86%) reported the means of RT; nine studies compared mean and the national standard as expressed in percentage. Limited use of the national standard to report RT was identified as a challenge to EMS assessment. Further, the inconsistency that exists when comparing RT in terms of means and percentage is a challenge to the validity of judgments expressed in some previous studies. Employment of uniform methods to report and evaluate performance based on the national standard will lead to greater transparency in emergency operation performance.


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