低・中所得国における病院前救急医療体制統合化の実践と課題(Integration of prehospital emergency medical service systems in low– and middle–income countries: Lessons from Command and Control Center Implementation in Vientiane, Capital of the Lao PDR)

Key Points

• The report examines the integration of fragmented emergency transport systems in low- and middle-income countries, focusing on success and limitations from a case study in Laos.
• Implemented from 2021 to 2024 with collaboration between Tsukuba University, Social Systems Research Institute, and Mitaphap Hospital.
• Standardized reporting numbers, established a command center, introduced electronic transport records, and provided training.
• Analyzed six primary data sources including transport records, meeting minutes, and field observations.
• Increased efficiency in dispatch operations and reduced arrival times at the scene were observed at the command center's initial phase.
• Standardization of recorded data and strengthened collaboration with medical facilities were achieved, but operations ceased in 2024 due to various factors.
• Challenges included funding shortages, high personnel turnover, delayed technology adaptation, weak interdepartmental cooperation, lack of public participation, and absent legal frameworks.