Spatial Accessibility Assessment of Prehospital EMS with a Focus on the Elderly Population: A Case Study in Ningbo, China

Abstract

The spatial accessibility of prehospital EMS is particularly important for the elderly population’s physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people’s spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address this issue involves using geographic information systems (GIS)-based tools to evaluate the spatial accessibility in conjunction with the spatial distribution of aging people, available road networks, and prehospital EMS facilities. This study employed gravity model and empirical Bayesian Kriging (EBK) interpolation analysis to evaluate the elderly’s spatial access to prehospital EMS in Ningbo, China. In our study, we aimed to solve the following specific research questions: In the study area, “what are the characteristics of the prehospital EMS demand of the elderly?” “Do the elderly have equal and convenient spatial access to prehospital EMS?” and “How can we satisfy the prehospital EMS demand of an aging population, improve their spatial access to prehospital EMS, and then ensure their quality of life?” The results showed that 37.44% of patients admitted to prehospital EMS in 2020 were 65 years and older. The rate of utilization of ambulance services by the elderly was 27.39 per 1000 elderly residents. Ambulance use by the elderly was the highest in the winter months and the lowest in the spring months (25.90% vs. 22.38%). As for the disease spectrum, the main disease was found to be trauma and intoxication (23.70%). The mean accessibility score was only 1.43 and nearly 70% of demand points had scored lower than 1. The elderly’s spatial accessibility to prehospital EMS had a central-outward gradient decreasing trend from the central region to the southeast and southwest of the study area. Our proposed methodology and its spatial equilibrium results could be taken as a benchmark of prehospital care capacity and help inform authorities’ efforts to develop efficient, aging-focused spatial accessibility plans.

Navigating Aged Care Services with GIS: Trends, Developments, and Future Directions

“…This makes it possible to process as much spatial data as possible through GIS techniques. Huanhuan Zhu 2021 [ 25 ] China Elderly aged 65 and above who used the ambulance in 2020 Quantitative: gravity model, empirical Bayesian Kriging (EBK) interpolation analysis Interpolation, preliminary mapping, buffer analysis, kernel density and overlay analysis Using GIS-based tools to evaluate the spatial accessibility in conjunction with the spatial distribution of aging people, available road networks, and prehospital EMS facilities. The elderly’s spatial access to prehospital EMS was imbalanced in the study area.…”

“…Among the 61 articles reviewed, the needs of older adults were categorized into medical care, basic living, transportation, and spiritual needs. A total of 37 articles focused on medical care [ 3 , 15 , 16 , 20 , 21 , 23 , 24 , 28 , 29 , 31 , 32 , 36 , 37 , 39 – 41 , 43 , 45 – 50 , 50 , 51 , 53 , 54 , 56 , 57 , 60 , 63 – 68 , 72 ], 14 articles addressed basic living needs [ 14 , 18 , 26 , 27 , 30 , 35 , 38 , 44 , 52 , 55 , 58 , 61 , 62 , 69 ], 8 articles discussed transportation needs [ 19 , 22 , 25 , 34 , 42 , 70 , 71 , 73 ], and 2 articles explored spiritual needs [ 17 , 33 ].…”

“…The ABM (Agent-Based Modeling) method was used in three articles [ 20 , 23 , 26 ]. Notably, 27 articles employed GIS to study accessibility issues [ 17 – 21 , 23 , 25 , 29 – 31 , 33 , 36 , 37 , 39 – 42 , 44 , 46 , 48 , 50 – 52 , 63 , 67 – 69 ].…”

Improving urban emergency medical service systems through brownfield transformation in Huangshi, China

“…Previous studies by Jientrakul et al (2022) 57 , Zhu et al (2021) 58 , and Chen et al (2016) 59 focused on optimizing ambulance allocation to ensure patients reach the nearest EMS facility but did not address whether these facilities could accommodate all transferred patients. In major public health emergencies, most city EMS facilities may exceed their maximum capacity.…”

Spatial Equality of Urban Care Facilities from the Perspective of Refinement: An Example from Changchun, China

“…In the context of public service facilities, spatial accessibility refers to the potential of care facilities to interact with seniors, focusing on measuring service access disparities between supply and demand due to spatial separation [24,25]. The nearest neighbor method [26], the gravity model method [27,28], and the two-step floating catchment area (2SFCA) method are the primary approaches used to study spatial accessibility [29,30]. The 2SFCA method provides a joint measurement from both the supply and demand perspectives, considering both the supply potential of available care facilities and the competitive pressure on care resources, making the measurement more realistic [31,32].…”