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Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study
AIM: To investigate (1) the association between pre-hospital emergency medical resources and pre-hospital emergency medical system (EMS) response time among patients with Out-of-hospital cardiac arrest (OHCA); (2) whether the association differs between urban and suburbs. METHODS: Densities of ambul...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986292/ https://www.ncbi.nlm.nih.gov/pubmed/36891343 http://dx.doi.org/10.3389/fpubh.2023.1121779 |
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author | Jin, Yinzi Chen, Hui Ge, Hongxia Li, Siwen Zhang, Jinjun Ma, Qingbian |
author_facet | Jin, Yinzi Chen, Hui Ge, Hongxia Li, Siwen Zhang, Jinjun Ma, Qingbian |
author_sort | Jin, Yinzi |
collection | PubMed |
description | AIM: To investigate (1) the association between pre-hospital emergency medical resources and pre-hospital emergency medical system (EMS) response time among patients with Out-of-hospital cardiac arrest (OHCA); (2) whether the association differs between urban and suburbs. METHODS: Densities of ambulances and physicians were independent variables, respectively. Pre-hospital emergency medical system response time was dependent variable. Multivariate linear regression was used to investigate the roles of ambulance density and physician density in pre-hospital EMS response time. Qualitative data were collected and analyzed to explore reasons for the disparities in pre-hospital resources between urban areas and suburbs. RESULTS: Ambulance density and physician density were both negatively associated with call to ambulance dispatch time, with odds ratios (ORs) 0.98 (95% confidence interval [CI] 0.96–0.99; P = 0.001) and 0.97 (95% CI; 0.93–0.99; P < 0.001), respectively. ORs of ambulance density and physician density in association with total response time were 0.99 (95% CI: 0.97–0.99; P = 0.013) and 0.90 (95% CI: 0.86–0.99; P = 0.048). The effect of ambulance density on call to ambulance dispatch time in urban areas was 14% smaller than that in suburb areas and that on total response time in urban areas was 3% smaller than the effect in suburbs. Similar effects were identified for physician density on urban–suburb disparities in call to ambulance dispatch time and total response time. The main reasons summarized from stakeholders for a lack of physicians and ambulances in suburbs included low income, poor personal incentive mechanisms, and inequality in financial distribution of the healthcare system. CONCLUSION: Improving pre-hospital emergency medical resources allocation can reduce system delay and narrow urban-suburb disparity in EMS response time for OHCA patients. |
format | Online Article Text |
id | pubmed-9986292 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99862922023-03-07 Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study Jin, Yinzi Chen, Hui Ge, Hongxia Li, Siwen Zhang, Jinjun Ma, Qingbian Front Public Health Public Health AIM: To investigate (1) the association between pre-hospital emergency medical resources and pre-hospital emergency medical system (EMS) response time among patients with Out-of-hospital cardiac arrest (OHCA); (2) whether the association differs between urban and suburbs. METHODS: Densities of ambulances and physicians were independent variables, respectively. Pre-hospital emergency medical system response time was dependent variable. Multivariate linear regression was used to investigate the roles of ambulance density and physician density in pre-hospital EMS response time. Qualitative data were collected and analyzed to explore reasons for the disparities in pre-hospital resources between urban areas and suburbs. RESULTS: Ambulance density and physician density were both negatively associated with call to ambulance dispatch time, with odds ratios (ORs) 0.98 (95% confidence interval [CI] 0.96–0.99; P = 0.001) and 0.97 (95% CI; 0.93–0.99; P < 0.001), respectively. ORs of ambulance density and physician density in association with total response time were 0.99 (95% CI: 0.97–0.99; P = 0.013) and 0.90 (95% CI: 0.86–0.99; P = 0.048). The effect of ambulance density on call to ambulance dispatch time in urban areas was 14% smaller than that in suburb areas and that on total response time in urban areas was 3% smaller than the effect in suburbs. Similar effects were identified for physician density on urban–suburb disparities in call to ambulance dispatch time and total response time. The main reasons summarized from stakeholders for a lack of physicians and ambulances in suburbs included low income, poor personal incentive mechanisms, and inequality in financial distribution of the healthcare system. CONCLUSION: Improving pre-hospital emergency medical resources allocation can reduce system delay and narrow urban-suburb disparity in EMS response time for OHCA patients. Frontiers Media S.A. 2023-02-20 /pmc/articles/PMC9986292/ /pubmed/36891343 http://dx.doi.org/10.3389/fpubh.2023.1121779 Text en Copyright © 2023 Jin, Chen, Ge, Li, Zhang and Ma. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Jin, Yinzi Chen, Hui Ge, Hongxia Li, Siwen Zhang, Jinjun Ma, Qingbian Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study |
title | Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study |
title_full | Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study |
title_fullStr | Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study |
title_full_unstemmed | Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study |
title_short | Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study |
title_sort | urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: a mixed-method cross-sectional study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986292/ https://www.ncbi.nlm.nih.gov/pubmed/36891343 http://dx.doi.org/10.3389/fpubh.2023.1121779 |
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