Analysis of the relationships between the determinants influential in performance of pre-hospital emergency system of iran using the DEMATEL approach

Abstract

Introduction: Emergency care must be understood as a complete system with independent components. Considering the high statistics of the cardiovascular diseases and unintentional events in Iran, the pre-hospital emergency system in the country needs fundamental changes. The aim of this study is to identify the determinants influential in performance of the pre-hospital emergency system of Iran and analysis of the relationships among them. Methodology: This research is of the comparative-descriptive studies type, and it has been accomplished by using cross -sectional design during the first half of the year 2009. The research population included 10 pre-hospital emergency experts, and special forms, together with Nominal Group Technique (NGT), were used as data gathering tools. Also the DEMATEL approach and MATLAB software were used for analysis of the data. Findings: The most important determinants influential in the performance of the Pre-hospital emergency system of Iran include the "organization," "transportation," "communications," "accessibility," "care model," "manpower combination," "regulations," and the "training," among which the "organization" and the "care model" have been identified as the most influential and the most influenced determinants respectively. Discussion: Although the prep-hospital emergency system of Iran has grown quantitatively, to develop fundamentally from both the qualitative and the quantitative point of view, it needs structural modifications which will establish an independent emergency medical care organization, and integrated management of pre-hospital and hospital emergency systems. Compiling the regulations and standards of reviewing the specialized training courses while training the people are also of considerable importance for implementing reforms