Emergency Medical Service (EMS) increases survival rates and reduces possible disability among emergency patients. However, the number of requests is relatively low in Thailand.

To inspect the awareness, perspective, and reasons behind the rejection of EMS by patients or their relatives who visit the emergency room.

Responses were analyzed in 45 government, university, and private hospitals from December 2015 to February 2016. The hospitals were scattered in 7 provinces with the sample group including 2,028 patients, whereby 646 patients visited using EMS and 1,368 did not. The key reasons for self-visit or other means are the convenience of personal transportation (76.0%), not wanting to wait for an ambulance (31.0%), and anxiety caused by the emergency situation (28.9%). Most misconceptions about the service include; 1) Ambulances are used only for casualties from accidents and 2) Ambulance service are not free. In terms of perspective, most patients or relatives hold a negative view towards the emergency medical service, especially the idea that they can help themselves when the condition is not severe or if there are medications or relief devices available. Another view is that the service will delay them from getting to the hospital. These perspectives are from non-users.

The study indicated that the cause of non-user involved misunderstandings, poor perspectives, lack of awareness, and the ignorance of the threat of the particular emergency condition. Thus, they do not realize the benefit of using EMS. As a result, regional agencies, the National Institute of Emergency Medicine, and the Ministry of Public Health should discuss the solutions to raise public awareness and improve the perspective towards emergency medical services to promote more usage.