Organizational structures, coordination, and financing mechanisms among governmental emergency medical teams in the European region: a cross-case analysis

Introduction: Emergency Medical Teams (EMT) are groups of health professionals and support staff who provide direct medical care during disasters, outbreaks, and conflicts. Defining strong EMT organizational structures, coordination, and financing mechanisms is a crucial part of EMT development and is expected to impact the timeliness and effectiveness of EMT response. Yet there is a lack of research exploring these aspects. This study aimed to map and compare organizational structures, coordination, and financing mechanisms of classified governmental EMTs in the World Health Organization (WHO) European Region. Methods: Qualitative document analysis and cross-case comparisons were used. Eight classified governmental EMTs in the European region shared documentation: DEMA - DEMH EMT2 (Denmark), NOR EMT (Norway), EMT2 Toscana (Italy), UK-EMT, Swiss Humanitarian Aid, START-AECID (Spain), L-EMT (Lithuania), and RO. EMT1 Bucharest (Romania). Documents were analyzed using both deductive and inductive selective coding, and themes were compared across cases using a matrix. Results: While all adhering to the WHO EMT standards, EMTs exhibit considerable variation in organizational models. Some of the most notable differences are found in their organizational ownership and management, human resource management policies, deployment activation procedures, logistics arrangements, and EMT financial responsibility. Conclusion: The results of this study provide insight into how governmental EMTs can be structured, which will guide countries in future EMT development and reform. Building on the foundations offered in this study, future research should generate evidence about key organizational policies and their practical implications.