AUTHOR=Jin Yinzi , Chen Hui , Ge Hongxia , Li Siwen , Zhang Jinjun , Ma Qingbian 

TITLE=Urban–suburb disparities in pre-hospital emergency medical resources and response time among patients with out-of-hospital cardiac arrest: A mixed-method cross-sectional study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1121779

DOI=10.3389/fpubh.2023.1121779

ISSN=2296-2565

ABSTRACT=Abstract 
Aim: To investigate (1) the association between pre-hospital emergency medical resources and pre-hospital emergency medical system (EMS) response time among patients with Out-of-hospital cardiac arrest (OHCA); (2) whether the associations differed between urban and suburbs.
Methods: The densities of ambulances and physicians were independent variables, respectively. The pre-hospital emergency medical system response time was dependent variable. Multivariate linear regression was used for outcomes. Qualitative data were collected and analysed to explore reasons for the disparities in pre-hospital resources between urban and suburbs
Results: Ambulance density and physician density were both negatively associated with call to ambulance dispatch time, with odds ratios (ORs) 0.98 (95% confidence interval [CI] 0.96–0.99; P=0.001) and 0.97 (95% CI; 0.93–0.99; P<0.001), respectively. ORs of ambulance density and physician density in association with total response time were 0.97 (95% CI: 0.97–0.99; P=0.013) and 0.90 (95% CI: 0.86–0.99; P=0.048). The effect of ambulance density on call to ambulance dispatch time in urban areas was 14% smaller than that in suburb areas and that on total response time in urban areas was 3% smaller than the effect in suburbs. Similar effects were identified for physician density on urban–suburb disparities in call to ambulance dispatch time and total response time. The main reasons for a lack of physicians and ambulances in suburbs included low income, poor personal incentive mechanisms, and inequality in financial distribution of the healthcare system.
Conclusion: Pre-hospital resources contribute to decreased pre-hospital EMS response time among OHCA patients and reduced gaps in pre-hospital EMS response time between urban and suburbs.