Abstract
This study examines the statewide service coverage of emergency medical services (EMS) in view of public health planners, policy makers, and ambulance service managers. The study investigates the statewide service coverage in a mixed region of urban, rural, and frontier regions to address the importance of ambulance service coverage at a large scale. The study incorporated statewide road networks for ambulance travel time, census blocks for population, and backup service coverage using geographic information systems (GIS). The catchment areas were delineated by the travel time after subtracting chute time for each Census Block as an analysis zone. Using the catchment areas from the ambulance base to the centroid of Census Block, the population and land coverage were calculated. The service shortage and multiple coverage areas were identified by the catchment areas. The study found that both reducing chute time and increasing the speed of emergency vehicles at the same time was significantly more effective than improving only one of two factors. The study shows that the service is improved significantly in frontier and urban areas by increasing driving time and chute time. However, in rural areas, the improvement is marginal owing to wider distribution than urban areas and shorter threshold response time than frontier areas. The public health planners and EMS managers benefit from the study to identify underserved areas and redistribute limited public resources.
Highlights
Since the 1960s, Emergency Medical Service (EMS) care has increased its geographic reach to cover the entire United States [1]
Our model investigates the statewide service coverage based on regional types of urban, rural, and frontier to address the importance of the ambulance location services of the state using geographic information systems (GIS)
Considering the pre-hospital emergency response time (Figure 3), the analysis of the service coverage according to the emergency response time showed that ambulance coverage with relatively high service concentration is receiving multiple services as expected
Summary
Since the 1960s, Emergency Medical Service (EMS) care has increased its geographic reach to cover the entire United States [1]. Local government or community may contract with ambulance suppliers to provide services to the community, thereby setting target average response times [3]. EMS agencies serve patients in various regions ranging from urban settings to locations in rural areas. While much more is known about ambulance coverage for urban areas, there are insufficient and unequal pre-hospital services in rural and remote regions [5,6,7,8]. Emergency calls and the need for emergency medical providers are growing, especially in rural and remote communities. Rural and frontier areas are especially challenging to respond to the calls because of extended distances, sparse populations, increased costs, and shortage of healthcare resources [7,9,10,11,12]
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