Thailand emergency medical system faces major gaps as 2,574 subdistricts lack units

Thailand still has 2,574 subdistricts without adequate standard emergency medical units, while a Senate working group is pushing for expanded local coverage and plans to increase the number of paramedics to 7,500 within five years.

Senator Dr Premsak Piayura, chairman of a working group studying reforms to crisis management and emergency medical services through digital technology under the Senate Committee on Information Technology, Communications and Telecommunications, revealed the findings following the group’s latest meeting on 13 September.

The review found major gaps in coverage, staffing and emergency response units, particularly in thousands of subdistricts where residents still lack access to standard emergency medical services.

Fiscal 2025 data showed that 4,861 subdistricts, or 65.38%, had standard medical response units, while 2,574 subdistricts, or 34.62%, did not have sufficient units to serve residents.

By region, the Northeast had the highest coverage at 75.06%, followed by the North at 71.70% and the South at 67.68%. The Central region had the lowest coverage at 46.62%.

Phuket had 100% coverage, followed by Lamphun at 98.04% and Satun at 94.44%.

Among the provinces with the lowest coverage were Samut Songkhram at 27.78%, Phra Nakhon Si Ayutthaya at 29.67% and Ang Thong at 34.25%.

Advanced medical response units averaged just 1.76 units per 100,000 people, or roughly one unit for every 56,818 people, below the reference level used in the study. Only 39 provinces had at least two standard advanced units per 100,000 people.

Thailand’s emergency medical system begins with emergency reports made through the 1669 hotline and digital channels, followed by patient triage, dispatch of response units, treatment at the scene, transportation and transfer to hospital.

Authorities have also developed the National Digital Emergency Medical Services Platform, or NDEMS, and the RNIS emergency call and dispatch system to connect information, identify callers’ locations, manage incoming calls, record contact histories and support real-time responses during crises and disasters.

Premsak said Thailand currently has 92 emergency medical command units and 5,521 approved medical response units, including 4,372 basic units, 1,102 advanced units and 102 specialist units. Some units are classified at more than one level.

The system has 7,449 professional medical personnel, including 1,798 emergency physicians, 3,779 emergency nurse practitioners and just 1,790 paramedics.

There are also more than 135,353 support personnel, including 111,605 emergency medical volunteers.

Thailand has 9,841 EMS vehicles, comprising 9,641 patient transport vehicles and 200 support vehicles.

A total of 15,092 emergency medical service vehicles had been certified to standards between 2021 and 30 June 2026.

Authorities have also developed the Thai Sky Doctor system to reach patients in remote areas, difficult terrain and islands, as well as places where ground transport is difficult.

Air medical missions have continued between fiscal 2022 and 2026. As of 30 June this year, there were 37 air medical response units, while 956 people had completed 21 Basic HEMS training courses.

Emergency medical services by sea are also being developed in key areas to coordinate locations and transfer assistance to people in distress.

A key target is for critically ill emergency patients to receive a response within eight minutes.

However, the study identified several major obstacles, including gaps in coverage, too few advanced response units, shortages of personnel — particularly paramedics — and limited specialist units for stroke, cardiac emergencies and serious trauma.

Premsak said the working group has proposed supporting capable local administrative organisations in setting up their own response units, increasing investment and staffing, identifying uncovered areas and upgrading basic units to advanced level.

It also proposed expanding fast-track systems for strokes, cardiac emergencies, road accidents, disasters and incidents involving large gatherings.

The group also plans to accelerate paramedic training through a “Paramedic Sandbox” project, with a target of increasing the workforce from the current 1,790 paramedics to 7,500 within five years.

The plan also calls for expanding training centres, increasing the number of assessors and developing Community First Responders in areas that still lack emergency response units.

The working group approved the proposals and will submit them to the relevant Senate subcommittee and committee for further consideration.

The meeting also approved a proposal to appoint Kitti Wongthawornawat and Nattanan Thatphithakkul as two additional members of the working group studying reforms to Thailand’s crisis management and emergency medical system.