Abstract
The purpose of this study was to explore differences in characteristics of missions dispatched by Emergency Medical Services (EMS) between rural and urban areas of Riyadh province in Saudi Arabia (SA). It also aimed at identifying weaknesses related to utilization and Response Time (RT). The study retrospectively evaluated 146,639 completed missions in 2018 by measuring the utilization rate in rural and urban areas. The study shows there are six times more ambulance crews available for rural areas compared to urban. There were 22.1 missions per 1000 urban inhabitants and 11.2 missions per 1000 in rural areas. The median RT for high urgent trauma cases was 20.2 min in rural compared to 15.2 min in urban areas (p < 0.001). In urban areas, the median RT for high urgent medical cases was 16.1 min, while it was 15.2 min for high urgent trauma cases. Around 62.3% of emergency cases in urban and 56.5% in rural areas were responded to within 20.00 min. Women utilized EMS less frequently. The RT was increased in urban areas compared to previous studies. The RT in the central region of SA has been identified as equal, or less than 20.00 min in 62.4% of all emergency cases. To further improve adherence to the 20′ target, reorganizing the lowest urgent cases in the rural areas seems necessary.
Highlights
Any health system in the world should have an integrated Emergency Medical Services (EMS)system in place to deal with public health emergencies such as out-of-hospital cardiac arrest (OHCA), stroke, and Road Traffic Accidents (RTAs)
This study reveals that 67.8% of incoming calls to Call Center (CC) from rural areas were due to high urgent emergency cases, while in urban areas, the percentage of calls for the high urgent category was 50.8%, (p < 0.001)
Despite the EMS services being free of charge and easy to access, we found a substantial variation of services demand in urban areas compared to rural areas
Summary
Any health system in the world should have an integrated Emergency Medical Services (EMS). System in place to deal with public health emergencies such as out-of-hospital cardiac arrest (OHCA), stroke, and Road Traffic Accidents (RTAs). From the perspective of health equity, patient-centeredness, and time-centeredness, which are three out of six domains of healthcare quality declared by the Institute of Medicine [1], and people who are in urgent need of such services should be provided for regardless. Res. Public Health 2020, 17, 7944; doi:10.3390/ijerph17217944 www.mdpi.com/journal/ijerph
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