Emergency care facility access in rural areas within the golden hour?: Western Cape case study

Abstract

BackgroundRoad Safety is a major cause of death around the world and South Africa has one of the highest road fatality rates. Many measures, engineering and medical, are investigated. However, analysis of the accessibility of emergency care facilities is often overlooked. This paper aims to fill the gap between pre-crash engineering solutions and literature on trauma injuries and emergency care procedures. The focus is on the role that accessibility to emergency care facilities in rural areas plays, given that 50% of the world’s population lives in rural areas, which are often omitted from international research. The Western Cape (a rural province with low population volumes and high volume roads in South Africa) is analysed as an example of access to trauma care in rural areas.MethodIt is internationally accepted that the time to emergency care facilities influences the survival chances. However, the international literature still debates the exact time period. In this paper, the ‘Golden Hour’ is used to analyse the accessibility of emergency care facilities in rural areas and establish a geographical analysis method which identifies risk areas. The analysis can be repeated if the international literature debates regarding the exact time period changes.ResultsA Geographical Information System (GIS) tool revealed that 53% of the fatalities in the rural parts of the Western Cape occur outside the Golden Hour. In high risk crash areas, the fatality risk is up to nine times higher than the province’s rural average.ConclusionsPeople in need of trauma care after a road crash are most likely to survive if they receive definitive care timeously. At the time of the study, the rural areas in the Western Cape had 44 Emergency Medical Services stations and 29 medical facilities that can assist to provide definitive (trauma) care. Further optimisation of the facility locations is recommended and research has begun.More advanced geographical modelling is possible when improved data becomes available on the ‘Golden Hour’ theory, differential times for varying injury types or travel speeds of ambulances. This, more advanced, modelling can reduce the road crash burden in rural areas around the world further.

Access and barriers to healthcare in the Kingdom of Saudi Arabia, 2013: findings from a national multistage survey

“…Therefore, in some countries, including South Africa, KSA and Portugal, distance to key populations is considered when planning on building new health facilities. [13][14][15] Saeed et al 16 found that the longer the distance travelled to primary healthcare centres in Riyadh, the lower the patients' satisfaction, with 39% of patients considering the primary healthcare centre far or very far. However, in our study, distance was not an issue, and we did not observe any association between type of healthcare facilities used or distance to healthcare facilities, and health outcomes or use of health services in KSA.…”

Medical Emergencies in Farmers

“…Delayed emergency care may also contribute to long‐term morbidity and mortality . Current trauma protocols emphasize the importance of rapid definitive medical care through the concepts of the “golden hour” and “scoop and run.” Past research suggests significant benefits of expedited medical care following acute injuries in the community or the battlefield . Delayed emergency care following agricultural injury has yet to be quantified and the potential adverse long‐term outcomes remain mostly speculative .…”

Factors Affecting the Location of Road Emergency Bases in Iran Using Analytical Hierarchy Process (AHP)

“…The results of other studies have shown that the distance of road emergency bases from each other is an effective factor in locating the road emergency bases [18][19][20]. Therefore, according to the importance of the distance of road emergency bases from each other, determining an index or formula to find the proper distance of these bases from each other is very important and should be a high priority for future studies.…”