Fogg Carole, King Phil, Parsons Vivienne, Dunbar Nicola, Woutersen Marcel, Branson Julia, Pocock Helen, Jadzinski Patryk, Lofthouse-Jones Chloe, Walsh Bronagh, Smith Dianna
School of Health Sciences, University of Southampton, Southampton, UK
South Central Ambulance Service NHS Foundation Trust, Bicester, UK.
BMJ Open Qual. 2025 Apr 24;14(2):e002977. doi: 10.1136/bmjoq-2024-002977.
Ambulance trusts across the UK serve vast and varied regions, impacting equitable healthcare access, especially for older patients facing urgent, non-life-threatening conditions. Detailed variation in demand and service provision across these regions remains unexplored but is crucial for shaping effective care policies and organisation. Geospatial mapping techniques have the potential to improve understanding of variation across a region, with benefits for service design.
To explore the feasibility of using geospatial techniques to map emergency 999 calls and outcomes for older adults within an academic-healthcare collaboration framework.
The study used administrative and clinical data for patients aged ≥65 who made urgent calls to a regional ambulance service within 1 year. This data, aggregated by geographical area, was analysed using geospatial software (ArcGIS) to create detailed choropleth maps. These maps displayed metrics including population demographics, number of calls, response times, falls, dementia cases and hospital conveyance rates at the middle-layer super output area level. Feedback was solicited from internal stakeholders to enhance utility and focus on service improvements.
The analysis unveiled significant regional disparities in emergency call frequencies and ambulance requirements for older adults, with notable variations in hospital conveyance rates, ranging from 22% to 100% across different areas. The geographical distribution of falls and calls for people with dementia corresponded with the older population's distribution. Response times varied by location. Stakeholders recommended additional data incorporation for better map utility and identified areas for service enhancement, particularly in addressing conveyance rate disparities for falls.
Leveraging aggregated ambulance service data for geospatial mapping of older adults' care demand and provision proves to be both feasible and insightful. The significant geographical variances in hospital conveyance highlight the need for further research. The development of academic-healthcare partnerships promotes resource and sharing of expertise, which should substantially benefit patient care for this vulnerable group.
英国各地的救护车信托机构服务于广阔且多样的地区,这影响了医疗服务的公平可及性,尤其是对于面临紧急但非危及生命状况的老年患者而言。这些地区在需求和服务提供方面的详细差异尚未得到充分探索,但对于制定有效的护理政策和组织架构至关重要。地理空间映射技术有潜力增进对一个地区差异的理解,对服务设计有益。
探讨在学术 - 医疗合作框架内,使用地理空间技术绘制老年人紧急999呼叫及结果地图的可行性。
该研究使用了年龄≥65岁的患者在1年内向地区救护车服务机构拨打紧急电话的行政和临床数据。这些按地理区域汇总的数据通过地理空间软件(ArcGIS)进行分析,以创建详细的分级统计图。这些地图展示了包括人口统计数据、呼叫次数、响应时间、跌倒情况、痴呆病例以及中层超级输出区域层面的医院转运率等指标。向内部利益相关者征求反馈意见,以提高实用性并专注于服务改进。
分析揭示了老年人紧急呼叫频率和救护车需求方面存在显著的地区差异,医院转运率差异显著,不同地区从22%到100%不等。跌倒情况和痴呆患者呼叫的地理分布与老年人口分布相对应。响应时间因地点而异。利益相关者建议纳入更多数据以提高地图实用性,并确定了服务改进领域,特别是在解决跌倒患者的转运率差异方面。
利用汇总的救护车服务数据进行老年人护理需求和服务提供的地理空间映射被证明是可行且富有洞察力的。医院转运方面的显著地理差异凸显了进一步研究的必要性。学术 - 医疗伙伴关系的发展促进了资源和专业知识的共享,这将极大地惠及这一弱势群体的患者护理。