Statewide Ambulance Coverage of a Mixed Region of Urban, Rural and Frontier under Travel Time Catchment Areas

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.

The association of crash response times and deaths at the crash scene: A cross‐sectional analysis using the 2019 National Emergency Medical Service Information System

“…32 Despite this decline, there are substantial regional and rural‐urban differences in ECIT with a recent study reporting that ECIT in the MidWest urban and rural areas range from 2 to 5 minutes, and 4 to 6 minutes, respectively. 33 This study found that about two‐thirds of persons exposed to crashes had ECIT of 1 minute or less at all times of the day with the proportion slightly larger during the rush hour compared to the nonrush hour period. However, about half of the persons exposed to crashes in rural areas experienced ECIT longer than a minute compared to a third of those exposed to crashes in urban areas.…”

Neuroethics across the Disorders of Consciousness Care Continuum

“…Possible measures could include relaxation of regulations on interstate and cross-border ambulance travel, increasing availability of emergency air transportation, speed regulations for emergency vehicles, geographical backup coverage, and reduced chute times (i.e., delays in EMS call dispatch and travel). 118 Improvements in emergency response systems may also be facilitated by capacity building in underserved areas, telemedicine systems, 119 and standards for establishing centers equipped to receive patients with acute DoC. 114 120 121 122 123 124 125 126…”

“…Possible measures could include relaxation of regulations on interstate and cross-border ambulance travel, increasing availability of emergency air transportation, speed regulations for emergency vehicles, geographical backup coverage, and reduced chute times (i.e., delays in EMS call dispatch and travel). 118 Improvements in emergency response systems may also be facilitated by capacity building in underserved areas, telemedicine systems, 119 and standards for establishing centers equipped to receive patients with acute DoC. 114,[120][121][122][123][124][125][126] Another area of ethical concern is ensuring that prehospital care and triage reflect patients' values and goals.…”

Spatial key performance indicators on the statewide ambulance service coverage of multiple regional classifications

“…Expected response time defines the service coverage. The response time of the prehospital care EMS is a sum of chute time and travel time of total EMS mission time (Lee, McDonald, O'Neill, & Montgomery, 2021; Tansley et al., 2016; Ulteig, 2013). Chute time is an interval between the time an ambulance crew or first responders are notified and the ambulance is en route .…”

“…The case study carried out here was inspired by the ambulance service area map in North Dakota (State of North Dakota, 2009) and Lee et al. (2021). North Dakota is classified as a rural state, and the state maintains urban, rural, and frontier areas for prehospital services.…”