Objective  To understand the problems of cross-regional prehospital emergency services in Kunshan City, and to provide basis for improving the prehospital emergency services.

  Methods  The data of 154 234 first aid cases in Kunshan prehospital emergency center from 2015 to 2019 were analyzed, using R software version 4.0.4 and Sankey diagram to visually display the transfer process. The intra-regional and inter-regional first-aid transportation of patients in different districts and towns were compared, and the possible reasons for delay of first-aid response time in Kunshan City were analyzed.

  Results  From 2015 to 2019, the stations that undertook major first aid tasks in Kunshan City mainly include the First Aid Center, the Sub-station in the Development Zone and Zhangpu First Aid Station. Most emergency patients were mainly from Yushan Town, the Development Zone and Zhoushi Town. Totally 96 597 patients (62.63%) were transported within the same region, and 57 637 patients (37.37%) were transported across regions. The proportion of inter-regional transferred patients in different districts and towns was different (P < 0.01), and the highest were in Dianshanhu Town and Zhouzhuang Town where there have no emergency stations established. The average time of intra-regional first-aid response of Kunshan City was 12.40 minutes, and the average time of inter-regional first-aid response was 15.65 minutes. The difference was of significance (P < 0.01). The first-aid time of 87 286 patients (56.80%) was less than 12 minutes (specified time limit) and among these 65 059 patients (74.54%) were intra-regionally transported. Among the patients with emergency response time > 12 minutes, 31 207 patients (47.01%) were intra-regionally transported.

  Conclusions  The reaction time of prehospital first aid in Kunshan City was closely related to intra-regional or inter-regional first-aid transportation. First aid stations need to be reasonably arranged, and corresponding first aid stations should be set up in areas without first aid stations, so as to shorten the first aid response time and improve the aid efficiency.