Emergency Medical Services (EMS) or prehospital services consist of the Emergency Medical Dispatch (EMD), the ambulance services, medical doctors, first responders and other prehospital resources. In this report the focus is on the EMD and the ambulance service. 

The EMS are in transition in the Nordic countries with similar trends worldwide. Increase in population, longer life expectancy and a rapidly growing elderly population increase the need for health care services, including EMS out of hospital. Centralizing and specializing, both in hospital health care and primary health care, also strengthens the need for well-organized EMS in the future. In most countries the expenditure on EMS is increasing because of this trend. 

The health care services are increasingly being transferred out of the hospital setting. The ability for prehospital diagnostic and treatment demands improved qualifications for the prehospital personnel to enable them to start advanced medical treatment to patient groups suffering from different complex health condition.

The Nordic countries are among the top-ranking health care services and have a long tradition of collecting data, documenting and publishing their outcomes for the patients. However, we've exeperienced that for the Nordic EMS this is not the case. This report presents the first set of Nordic EMS quality indicators and the challenges in increasing the knowledge about the EMS' performance of patient centered care in the Nordic countries.

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