Public–private implementation of integrated emergency response services: Case study of GVK Emergency Management and Research Institute in Karnataka, India

Document Type

Journal Article

Publication Date



Surgery (United States)








© 2017 Elsevier Inc. Background Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public–private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru. Methods A case study methodology was used to explore systematically the organizational model of GVK Emergency Management and Research Institute in Karnataka. Qualitative data were collected through an in-person site visit to GVK Emergency Management and Research Institute headquarters in Bengaluru in July 2013. Three sources were used: in-depth, semistructured interviews, document review, and nonparticipant observation. Data were analyzed according to the health system “building blocks” proposed by the World Health Organization. Results The organization follows a standardized model across the states and union territories where they have contractual arrangements, including Karnataka. Processes for fleet maintenance, information systems/information technology and training, and deployment were well structured at the organizational level. The public–private partnership appears pro-poor in orientation; however, further demand-side research is required on the perspective of patients. Conclusion Our study reveals a functional structure at the organizational level, which provides a key service at no cost to users. Detailed analyses of this nature can help inform global efforts for the development and strengthening of emergency medical services systems.