Objective: To compare the characteristics of the emergency medical services (EMS) brought COVID-19 patients versus self-referred walk-in patients. Methods: This was a Cross-sectional study of COVID-19 infected cases in Jahrom, south of Iran. Age, sex, the symptoms of beginning days’,passing, respiratory distress, PO2 at arrival, admission length and inhospital death were retrieved for confirming COVID-19 cases in the whole 2020 year. Respiratory distress was considered as the sign that agitates the patient to call EMS care. Survival analysis was used to evaluate the possible difference of the hospitalization outcome in EMS brought or Self-referred walk-in (SRW) patients. Results: There was 704 (27. 1%) registries patients transfer to the hospital by EMS and 1895 (72. 9%) cases with SRW referred to the hospital. The survival distributions for the EMS group were statistically significant and lower than SRW group (p<0. 05). Despite the SRW patients, respiratory distress was associated with lower survival in EMS group (p<0. 05). Days passing the symptom’, s beginning was significantly different between EMS group (6. 1±, 5. 3 days) and SRW group (6. 9±, 4. 6 days). Cox regression showed higher mortality rate in patients higher than 75 years old in both groups (p<0. 05). Higher PO2 at arrival was associated with lower mortality rate of Hazard Ratio of 0. 959 (p<0. 001) and 0. 903 (p<0. 001) in EMS and SRW groups, respectively. The history of heart disease and hypertension were associated with 1. 011 and 1. 088 times more than mortality risk in EMS group,while cancer history was associated with 2. 74 times more of mortality risk in SRW group. Conclusion: It seems that severe acute respiratory syndrome occurs soon in some patients that lead to the need for an ambulance to transfer the patient to the hospital. Therefore, EMS transfer patients should be considered for more risk of severe COVID-19,considering comorbidities of heart disease and hypertension as red flags.

Objective: Assessing patients’ satisfaction with emergency medical services (EMSs) is an important managerial point of view. The present study aimed to assess the patients’ satisfaction with EMS in Tabriz, Iran. Methods: This is a descriptive-analytic study that was done in the prehospital emergency and disaster management center of Tabriz University of medical Sciences. In this study, from May to December 2017, we included 659 patients who were transferred to hospitals with our prehospital emergency services. A valid and reliable questionnaire was used to evaluate the satisfaction of patients about the performance of prehospital EMSs. Results: Data of 659 patients were evaluated. Trauma was the most common cause of contact with 115 and help request (33. 83%). The results indicated that patients’ level of satisfaction was good and very good. The highest level of satisfaction was related to the treatment of patients and use of medical equipment in the ambulance (n=578 patients, 87. 7%) as well as the treatment practiced by the emergency medical technicians (EMTs) (n=575 patients, 87. 24%). However, the lowest level of satisfaction was related to the absence of an active EMT in the rear cabin when transferring patients to the hospital (n=337 patients, 51. 14%) and transfer of the patient from the accident scene to the ambulance (n=410 patients, 62. 21%). Conclusion: Patients’ satisfaction with EMS was optimal. The minimum and maximum satisfaction rates were related to the absence of an active EMT in the rear cabin, treatment of the patient, and use of medical equipment.

Background: Improving the organization of pre-hospital emergency to provide emergency medical services (EMS), as a part of health system, plays an important role in timely and properly response to incidents, as well as, reducing mortalities and disabilities.Objective: This study was conducted to determine the organizational determinants of emergency medical services in Iran and analyze their relationship and prioritize them.Materials and Methods: The present study is kind of descriptive and cross-sectional study that has been conducted on the first half of 2010 using DEMATEL method (a group decision-making technique). Required data were collected using a questionnaire from a sample of 30 Iranian experts in pre-hospital emergency, who were selected using available sampling method.Results: The determinants of establishing an independent EMS organization as a policy maker and observer organization, providing services through public organizations such as emergency 115, private organizations partnership in pre-hospital emergency system, and integrating pre-hospital and hospital emergency under single supervision and management were determined as organizational determinants. Also, establishing an independent EMS organization and integrating pre-hospital and hospital emergency under single supervision and management were determined as the most affecting and affected organizational determinants, respectively, with the coordinates (1.01 and 1.01) and (0.85 and - 0.85) in the pre-hospital emergency organizational determinants graph.Conclusions: emergency medical services should be considered as a system with its independent components. Establishing an independent EMS organization, integrating pre-hospital and hospital emergency under single supervision and management, as well as, extending the possibility of providing EMS through private sector are essential in order to make fundamental reforms in providing emergency medical services in Iran.

Introduction: One of the important aspects in high quality health care system is delivering health services in an appropriate way which can lead to development of the systems. Patient satisfaction is a quality indicator that has the potential to provide valuable information about the care delivered by an emergency medical services system (EMS). This indicator is considered as an important marker of quality by paramedics.Method: This is a descriptive- analytical study on 1096 patient satisfaction of emergency services suffering from cardiovascular, dyspnea, low level of consciousness and cerebral problems. Variables such as the type of diseases, technicians’ and operators' behavior, time of response and outcome of the missions were measured with a valid checklist. ANOVA and correlation Pearson were employed as analytical tests.Results: Considering different types of diseases, 4 categories of diseases had positive correlation with satisfaction of the patients and also there was a meaningful correlation between factors which were measured and satisfied patients. (P<0.001) Conclusion: Developing some instructions for technicians and operators focusing on interpersonal skills and enhanced sensitivities and behaviors not only toward patients but also toward bystanders and family members is recommended to improve patient satisfaction and thought quality of delivered care in the prehospital emergency medical systems.