Spatial accessibility of emergency medical services in Chongqing, Southwest China

Abstract

BackgroundTimely access to emergency medical services (EMS) can significantly reduce mortality. In China, the evidence of the accessibility of complete EMS which considers two related trips and involves large rural areas is insufficient. This study aimed to explore the accessibility of ambulance services and complete EMS in Chongqing and its regional differences, and to provide a reference for improving spatial accessibility of EMS in Chongqing and optimizing allocation of EMS resources.MethodsThe nearest neighbor method was used to measure spatial accessibility of ambulance services and complete EMS. Spatial aggregation patterns and influencing factors of spatial accessibility of complete EMS were analyzed using Moran's I index, Pearson correlation and multiple linear regression.ResultsThe medians of shortest travel time for ambulance, monitoring ambulance, primary EMS and advanced EMS in Chongqing were 7.0, 18.6, 36.2, and 47.8 min. The shortest travel time for complete EMS showed significant spatial aggregation characteristics. The Low-Low types that referred to cluster of short EMS travel time mainly distributed in city proper. The High-High types that referred to cluster of long EMS travel time mainly distributed in northeast and southeast of Chongqing. Urbanization rate was a negative influencing factor on shortest travel time for primary EMS, while average elevation and the number of settlements were positive influencing factors. GDP per capita and urbanization rate were negative influencing factors on shortest travel time for advanced EMS, while the number of settlements was a positive influencing factor.ConclusionThis study evaluated the accessibility of EMS which considers two related trips in Chongqing. Although the accessibility of ambulances in Chongqing was relatively high, the accessibility of monitoring ambulance was relatively low. Regional and urban-rural differences in the accessibility of complete EMS integrating two related trips were obvious. It was recommended to increase financial investment in economic backward areas, increase high-quality EMS resources, enhance EMS capacity of central township health centers, strengthen road construction in mountainous areas, and provide reasonable planning of rural settlements for improving the spatial accessibility of EMS, narrowing the urban-rural gap and improving equity in getting EMS for all the people.

Regional differences in health resource allocation: a longitudinal study in the Chengdu-Chongqing economic circle, China

“…There are five regions in Chongqing with good health resource allocation and four regions with poor health resource allocation, all of which account for the majority of the percentage, indicating that the polarisation of health resource allocation in Chongqing is more serious. This is consistent with the findings that there are significant regional and urban–rural differences in the accessibility of medical resources in Chongqing 33. The central urban area of Chongqing has a high level of economic development, a high population density and a better allocation of health resources.…”

“…This is consistent with the findings that there are significant regional and urban–rural differences in the accessibility of medical resources in Chongqing. 33 The central urban area of Chongqing has a high level of economic development, a high population density and a better allocation of health resources. The central urban area of Chongqing has more medical schools and more large hospitals, which attract a lot of medical and healthcare talents.…”

Spatial distribution and influencing factors of CDC health resources in China: a study based on panel data from 2016–2021

“…Urbanization can reflect the level of public health services in a region ( 39 ). A higher level of urbanization means more developed transportation and easier access to health care services ( 40 ). The population density is used to measure the demand for healthcare resources in an area, which also benefits the government in measuring how to allocate health expenditures ( 41 ).…”

Factors influencing civil servants' willingness to implement cardiopulmonary resuscitation in Chongqing, China: Based on the theory of planned behavior

“…The findings of Zheng [ 35 ] et al showed that 91.9 % of civil servants believed that they should be rescuers more than the general public. Chongqing Municipality is located in the relatively impoverished western region of China, with a relative lack of EMS resources, and the predominantly mountainous terrain increases prehospital time and reduces the spatial accessibility of prehospital emergency services [ 36 ]. Mutual aid and public self-rescue are therefore especially crucial.…”