Xu Ning, Bai Jianjun, Yan Ran
School of Geography and Tourism, Shaanxi Normal University, Xi'an, 710119, China.
Int J Equity Health. 2022 Apr 22;21(1):54. doi: 10.1186/s12939-022-01653-0.
Emergency department crowding is an obstacle in the process of obtaining emergency care services, which will lead to the increase of time cost. Most studies focused on the direct access to emergency medical resources, and few studies took the crowding of hospital emergency department as an evaluation index to reflect the convenience of obtaining emergency medical resources. It is a significance for the identification of areas with insufficient access to emergency service resources with this method.
This paper utilizes the improved potential model and the inverted Two-Step Floating Catchment Area method, combined with network map API service data to evaluate response time, delivery time and waiting time (for emergency department crowding) spent in different residential areas of Xi'an City in the process of emergency. Meanwhile, the vulnerable regions of gaining emergency medical resources are identified through the comprehensive analysis of the three stages of emergency.
The studies show that the residents in built-up area are more convenient to get ambulance service and arrive at care hospitals than those in suburban areas, but they may face greater hospital crowdedness. Although suburban residents are faced with low hospital crowdedness, they spend more time on getting ambulances and going to care hospitals. The accessibility of emergency medical resources varies greatly among residents in different regions, with 5.38% of the residents were identified in the high-risk area distributing in suburban residential areas in the south of the city center, 21.92% in the medium risk area in the southern mountainous areas and the periphery of the core suburban areas of the city, and 46.11% in the low-risk area which are mainly distributed in built-up areas in gaining emergency medical services.
Obviously, getting an ambulance and arriving at the nearest hospital quickly shows that it is conducive to access to emergency resources. However, the impact of hospital emergency crowding can not be ignored, especially in the area surrounded by high-grade hospitals in the central area of the city. In considering the spatial layout of emergency stations and emergency hospitals, the dislocation distribution of hospitals at different levels should be reasonably adjusted to balance the equity of residents in obtaining emergency medical resources.
急诊科拥挤是获取急诊医疗服务过程中的一个障碍，这将导致时间成本增加。大多数研究集中在直接获取急诊医疗资源上，很少有研究将医院急诊科的拥挤情况作为评估指标来反映获取急诊医疗资源的便利性。用这种方法识别急诊服务资源获取不足的地区具有重要意义。
本文利用改进的潜力模型和反向两步浮动集水区法，结合网络地图应用程序编程接口服务数据，评估西安市不同居民区在急诊过程中花费的响应时间、送达时间和等待时间（针对急诊科拥挤情况）。同时，通过对急诊三个阶段的综合分析，确定获取急诊医疗资源的脆弱区域。
研究表明，建成区居民比郊区居民更容易获得救护车服务并到达救治医院，但他们可能面临更大的医院拥挤情况。虽然郊区居民面临的医院拥挤程度较低，但他们在获取救护车和前往救治医院方面花费的时间更多。不同地区居民获取急诊医疗资源的可及性差异很大，5.38%的居民被确定为高风险区域，分布在市中心南部的郊区居民区；21.92%为中风险区域，位于南部山区和城市核心郊区周边；46.11%为低风险区域，主要分布在建成区，在获取急诊医疗服务方面。
显然，快速获得救护车并到达最近的医院表明有利于获取急诊资源。然而，医院急诊科拥挤的影响不可忽视，尤其是在城市中心高档医院周边地区。在考虑急救站和急救医院的空间布局时，应合理调整不同级别医院的错位分布，以平衡居民获取急诊医疗资源的公平性。
