Tzong-Luen Wang, MD, PhD; Hang Chang, MD, PhD

Abstract -- To investigate the impact of administrative regulations on improving the completeness and quality of pre-hospital recordings (PCRs), we compared the PCRs from ambulance agencies during two different periods, that is, from July 2004 to December 2004 (the first stage that administrative regulations has not yet been implemented) and from January 2005 to June 2005 (the second stage that administrative regulations has been implemented). Overall completeness and item-wise review were performed for each PCRs from inter-hospital transfer by ambulance agencies. There were 185 patients (Group A) who were transferred from this institute to other hospitals during the first stage 4 and 70 patients (Group B) transferred to other hospitals during the second stage. Sixty-eight percent (126/185) of PCRs from Group A were not fulfilled at all, and 30% (57/185) of these PCRs were not recorded completely. In contrast, 17% (12/70) and 21% (15/70) of the PCRs from Group B were lacking and incompletely recorded, respectively (P<0.01 between the two groups). Item-wise review of the available PCRs revealed that improvement were found in patient assessment findings (58/58 or 100% in Group B vs. 29/59 or 49%, P<0.01), care rendered before arrival to receiving hospitals (50/58 or 86% in Group B vs. 25/59 or 42%, P<0.05), clinical observations including responses to interventions (42/58 or 72% in Group B vs. 18/59 or 31%, P<0.05), and medical decision making (41/58 or 71% in Group B vs. 18/59 or 31%, P<0.05). In conclusion, this study demonstrated that implementation of administrative regulation and assurance of health policies was proven to improve such deficiencies. It is believed to be an essential step in disaster preparation.