Déziel Jackson D
School of Health Sciences, Western Carolina University, Cullowhee, NC, USA.
Disaster Med Public Health Prep. 2022 Apr 11;17:e119. doi: 10.1017/dmp.2022.26.
Variations in the demand for Emergency Medical Services (EMS) exist when observed at a local level. This unspecified heterogeneity leads to an investigation of social factors contributing to EMS demand.
Data for this study were collected from publicly available EMS reports from Florida and Oklahoma for 2009 - 2015. Health and social data were gathered from County health rankings and roadmap reports. Data were combined into a single dataset, and pooled ordinary-least-squares models with time-fixed effects were utilized for tests of inference. EMS call volume was log-transformed to derive a semi-elasticity function.
A total of 874 county-year observations were analyzed. Increases in poor/fair health (95% CI: 0.6% - 3.9%), binge drinking (95% CI: 1.6% - 3.5%), teen birth rate (95% CI: 1.1% - 5.2%), unemployment rate (95% CI: 0.5% - 3.9%), and violent crime rate (95% CI: 1.0% - 3.0%) were associated with an increase in the EMS demand rate.
The data supports the notion that some community measures have an effect on EMS demand as counties with higher levels of poor health, binge drinking, teen births, unemployment, and violent crime saw higher EMS demand. These factors may have been treated as spurious, or overlooked by policy makers and EMS leadership.
在地方层面观察时，紧急医疗服务（EMS）需求存在差异。这种未明确的异质性促使人们对影响EMS需求的社会因素进行调查。
本研究的数据收集自佛罗里达州和俄克拉荷马州2009 - 2015年公开的EMS报告。健康和社会数据则从县健康排名及路线图报告中获取。数据被整合到一个单一的数据集中，并使用具有时间固定效应的混合普通最小二乘法模型进行推断检验。对EMS呼叫量进行对数变换以得出半弹性函数。
共分析了874个县 - 年观测值。健康状况差/一般（95%置信区间：0.6% - 3.9%）、酗酒（95%置信区间：1.6% - 3.5%）、青少年出生率（95%置信区间：1.1% - 5.2%）、失业率（95%置信区间：0.5% - 3.9%）以及暴力犯罪率（95%置信区间：1.0% - 3.0%）的增加与EMS需求率的上升相关。
数据支持这样一种观点，即一些社区指标会对EMS需求产生影响，因为健康状况差、酗酒、青少年生育、失业和暴力犯罪水平较高的县，其EMS需求也更高。这些因素可能被政策制定者和EMS领导层视为虚假因素或被忽视了。
