Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Prehosp Emerg Care. 2013 Oct-Dec;17(4):458-65. doi: 10.3109/10903127.2013.811562. Epub 2013 Jul 18.
To derive and validate a model that accurately predicts ambulance arrival time that could be implemented as a Google Maps web application.
This was a retrospective study of all scene transports in Multnomah County, Oregon, from January 1 through December 31, 2008. Scene and destination hospital addresses were converted to coordinates. ArcGIS Network Analyst was used to estimate transport times based on street network speed limits. We then created a linear regression model to improve the accuracy of these street network estimates using weather, patient characteristics, use of lights and sirens, daylight, and rush-hour intervals. The model was derived from a 50% sample and validated on the remainder. Significance of the covariates was determined by p < 0.05 for a t-test of the model coefficients. Accuracy was quantified by the proportion of estimates that were within 5 minutes of the actual transport times recorded by computer-aided dispatch. We then built a Google Maps-based web application to demonstrate application in real-world EMS operations.
There were 48,308 included transports. Street network estimates of transport time were accurate within 5 minutes of actual transport time less than 16% of the time. Actual transport times were longer during daylight and rush-hour intervals and shorter with use of lights and sirens. Age under 18 years, gender, wet weather, and trauma system entry were not significant predictors of transport time. Our model predicted arrival time within 5 minutes 73% of the time. For lights and sirens transports, accuracy was within 5 minutes 77% of the time. Accuracy was identical in the validation dataset. Lights and sirens saved an average of 3.1 minutes for transports under 8.8 minutes, and 5.3 minutes for longer transports.
An estimate of transport time based only on a street network significantly underestimated transport times. A simple model incorporating few variables can predict ambulance time of arrival to the emergency department with good accuracy. This model could be linked to global positioning system data and an automated Google Maps web application to optimize emergency department resource use. Use of lights and sirens had a significant effect on transport times.
开发并验证一个能够准确预测救护车到达时间的模型,该模型可作为谷歌地图网络应用程序实现。
这是一项回顾性研究,涉及俄勒冈州芒特诺玛县 2008 年 1 月 1 日至 12 月 31 日期间的所有现场转运。将现场和目的地医院的地址转换为坐标。ArcGIS Network Analyst 用于根据街道网络限速估算运输时间。然后,我们创建了一个线性回归模型,使用天气、患者特征、使用灯光和警笛、白天和高峰时段来提高这些街道网络估算的准确性。该模型源自 50%的样本,其余部分用于验证。通过对模型系数进行 t 检验,确定协变量的显著性,p 值小于 0.05。通过估计值与计算机辅助调度记录的实际运输时间相差 5 分钟以内的比例来量化准确性。然后,我们构建了一个基于谷歌地图的网络应用程序,以展示在现实世界中的紧急医疗服务运营中的应用。
共纳入 48308 例转运。街道网络估计的运输时间准确,与实际运输时间相差 5 分钟以内的时间不到 16%。白天和高峰时段的实际运输时间较长,使用灯光和警笛的时间较短。年龄在 18 岁以下、性别、湿天气和创伤系统进入不是运输时间的显著预测因素。我们的模型预测到达时间在 5 分钟内的准确率为 73%。对于使用灯光和警笛的转运,准确率在 5 分钟内的准确率为 77%。验证数据集的准确性相同。灯光和警笛为转运时间少于 8.8 分钟的患者节省了平均 3.1 分钟,为转运时间较长的患者节省了 5.3 分钟。
仅基于街道网络的运输时间估计严重低估了运输时间。一个简单的模型,包含少量变量,可以很好地预测救护车到达急诊部的时间。该模型可以与全球定位系统数据和自动化谷歌地图网络应用程序连接,以优化急诊部资源利用。使用灯光和警笛对运输时间有显著影响。