Introduction: Effective planning to improve medical issues via EMS is an essential need.  This study aimed to evaluate the  causes, variety and factors associated with patients' dispatch via Medical Emergencies from different townships of Ilam province to Ilam city or cities from the other provinces and by a practical suggestion helps to improve the emergency cares at the event place.

Materials & methods: By a descriptive study all dispatched patients during March to August 2010 by Ilam province EMS were investigated consecutively. Demographic data and all information about causes and factors related to patients dispatch were collected via a valid questionnaire and finally the data were entered into the SPSS version16 and using descriptive tables and relevant tests were analysed.

 Findings: Totally 960 cases were referred to Ilam or other provinces during study project among which the highest figure (196 patients (20.4%)) was from Abdanan city and the least figure was from Ilam (59 (6.1%)) and 59% of patients was attributed to  males.  Also, the rates of patients from urban and rural areas were 73.1% and 26.3% respectively and 0.5% was among emigrants and visitors. 48% of referrals (449 patients) were due to accident and others were due to other different diseases and the highest rate of referrals (30.7) had surgical reasons and 22.9% was associated with cardiovascular diseases. In this study, the most patients' referrals (65.3%) were ordered by general medics and destination of 94% of referrals was Ilam city, inside the province. 97.3% of referrals was due to absent of relevant specialist and only 21.3% of referrals were due to emphasis of specialists upon the actual need of patients and the highest rate of referrals were due to lateral and unimportant reasons.

Discussion & conclusions: The most patients' dispatches were due to absence of relevant specialist and the highest rate of referrals had surgical reasons; therefore, employment of specialists particularly surgeon and settlement of diagnostic tools such as sonography, radiology and CT scan can considerably reduce the number of dispatches. Also, the highest number of referrals was ordered by general medics, which reveals lack of enough specialists in Ilam townships and absence of a regular referral system in this province.