title: Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India.
abstract: India has been slow in implementing a central emergency medical services (EMS) system across the country. "108 services" is one of the most popular services that is functional under the public-private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective.
  
  
  
  A questionnaire survey is conducted to understand the awareness of EMS and their function. Using traffic-related fatalities as the dependent variable, a fixed effect panel data model is developed to analyze the effectiveness of the 108 services in improving the traffic safety.
  
  
  
  The results from the survey show that, in general, people are not aware of the 108 services. A majority of the population prefers taking victims to the hospital using their personal vehicles or any other vehicles available compared to calling an ambulance. Results from panel data analysis show that despite having an efficient system, these services failed to make significant improvement in the safety of road users in the states in which their services were subscribed.
  
  
  
  The lack of awareness of an important safety service is alarming. This could be a major reason for lower utilization of 108 services for transporting victims of traffic crashes. This article shows the importance of having efficient awareness campaigns to improve the efficiency of any similar programs that are aimed to enhance the safety of a region.
authors.affiliation: a Department of Civil Engineering , Indian Institute of Technology Kanpur , Kanpur , India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Vasudevan
authors.affiliation: a Department of Civil Engineering , Indian Institute of Technology Kanpur , Kanpur , India.
authors.forename: Preeti
authors.initials: P
authors.lastname: Singh
authors.affiliation: a Department of Civil Engineering , Indian Institute of Technology Kanpur , Kanpur , India.
authors.forename: Samyajit
authors.initials: S
authors.lastname: Basu
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data; D004632:Emergency Medical Services; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D012449:Safety; D011795:Surveys and Questionnaires; D014186:Transportation / Q000706:statistics & numerical data; D055815:Young Adult
keywords: 108 services; EMS and traffic safety; Emergency medical services; effectiveness of EMS; panel data models; traffic safety in developing countries