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天气和时间模型在紧急医疗服务中的应用:泛化能力评估。

Weather and temporal models for emergency medical services: An assessment of generalizability.

机构信息

Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.

Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States of America.

出版信息

Am J Emerg Med. 2021 Jul;45:221-226. doi: 10.1016/j.ajem.2020.08.033. Epub 2020 Aug 16.

Abstract

BACKGROUND

Emergency medical services (EMS) response volume has been linked to weather and temporal factors in a regional EMS system. We aimed to identify if models of EMS utilization incorporating these data are generalizable through geographically disparate areas in the United States.

METHODS

We performed a retrospective analysis of EMS dispatch data from four regions: New York City, San Francisco, Cincinnati, and Marin County for years 2016-2019. For each model, we used local weather data summarized from the prior 6 h into hourly bins. Our outcome for each model was EMS dispatches as count data. We fit and optimized a negative binomial regression model for each region, to estimate incidence rate ratios. We compared findings to a prior study performed in Western Pennsylvania.

RESULTS

We included 5,940,637 EMS dispatches from New York City, 809,405 from San Francisco, 260,412 from Cincinnati, and 77,461 from Marin County. Models demonstrated consistency with the Western Pennsylvania model with respect to temperature, season, wind speed, dew point, and time of day; both in terms of direction and effect size when expressed as incidence rate ratios. Precipitation was associated with increasing dispatches in the New York City, Cincinnati, and Marin County models, but not the San Francisco model.

CONCLUSION

With minor differences, regional models demonstrated consistent associations between dispatches and time and weather variables. Findings demonstrate the generalizability of associations between these variables with respect to EMS use. Weather and temporal factors should be considered in predictive modeling to optimize EMS staffing and resource allocation.

摘要

背景

在区域紧急医疗服务(EMS)系统中,EMS 响应量与天气和时间因素有关。我们旨在确定是否可以通过美国地理上不同的地区来推广纳入这些数据的 EMS 使用模型。

方法

我们对四个地区(纽约市、旧金山、辛辛那提和马林县)的 EMS 派遣数据进行了回顾性分析:2016-2019 年。对于每个模型,我们使用前 6 小时汇总的本地天气数据到每小时的时间区间。我们的每个模型的结果是 EMS 派遣次数的计数数据。我们为每个地区拟合和优化了负二项回归模型,以估计发病率比值。我们将研究结果与在宾夕法尼亚州西部进行的先前研究进行了比较。

结果

我们纳入了来自纽约市的 5940637 次 EMS 派遣、来自旧金山的 809405 次、来自辛辛那提的 260412 次和来自马林县的 77461 次。在温度、季节、风速、露点和一天中的时间方面,模型与宾夕法尼亚州西部模型一致;当以发病率比值表示时,无论是方向还是效应大小。降水与纽约市、辛辛那提和马林县模型的派遣量增加有关,但与旧金山模型无关。

结论

在细微差异的情况下,区域模型显示了与派遣量和时间与天气变量之间的一致关联。这些发现表明,这些变量与 EMS 使用之间的关联具有可推广性。应在预测模型中考虑天气和时间因素,以优化 EMS 人员配置和资源分配。

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