Emergency medical services deployment for palliative care patients: Operational metrics, resource allocation, and patient outcomes.

BACKGROUND

Emergency medical services (EMS) encounters with palliative care patients present unique operational challenges. As EMS providers increasingly care for individuals with life-limiting illnesses, understanding the intersection of emergency care and palliative medicine has become essential to optimizing healthcare delivery.

OBJECTIVE

This study examines EMS operational metrics, resource allocation patterns, and clinical outcomes among palliative care patients in Thailand.

METHODS

This retrospective analysis study investigated operational times, resource utilization, and clinical outcomes in palliative care patients utilizing EMS services, derived from electronic medical records and EMS documentation. This study was conducted at the Srinagarind Hospital EMS unit from October 2019 to September 2024. All patients diagnosed with palliative care (ICD-10 code Z51.5) who utilized EMS services were included.

RESULTS

Palliative care patients represented 6.9% (N = 340) of total EMS utilization (N = 4520), with cases increasing from 51 patients (15.0%) in 2019-2020 to 89 patients (26.2%) in 2023-2024. The median age was 72 years, with 62.9% male patients. Palliative care patients demonstrated significantly prolonged EMS operational times: activation (1.51 min vs 1.27 min), response (10.21 min vs 9.35 min), and scene time (22.05 min vs 10.02 min, p < 0.001). Resource utilization showed higher rates of pain medication administration (30.88% vs 7.79%) and exclusive use of comfort-focused interventions. Patient outcomes revealed significantly higher discharge rates.

CONCLUSION

Palliative care patients utilizing EMS services represent a distinct population requiring specialized operational approaches. Extended scene times reflect appropriate symptom-focused care delivery rather than rapid transport protocols. Higher discharge rates validate the EMS role as a symptom management bridge.