Zhu Haolin, Xu Mo, Zhu Luying
School of Sciences for Human Habitat, University of Chinese Academy of Sciences, Beijing, China.
Beijing Emergency Medical Center, Beijing, China.
PLoS One. 2025 May 8;20(5):e0322656. doi: 10.1371/journal.pone.0322656. eCollection 2025.
Emergency Medical Services (EMS) are a critical component of public healthcare. This study aimed to precisely measure the spatiotemporal accessibility and equity of EMS in Shanghai. We constructed a research model that combines web mapping application programming interfaces (APIs) and empirical Bayesian kriging (EBK) interpolation methods to calculate EMS accessibility, and used the Theil index to assess the equity of EMS accessibility. Additionally, we used the Minimum Cumulative Resistance (MCR) Model to evaluate the rationality of EMS stations layout. The results indicated that the per capital response time (PRT) in Shanghai increased from 11.46 minutes during smooth traffic periods to 13.08 minutes during peak traffic periods, and the 12 min EAI population coverage rate dropped from 60.6% to 41.9%. Thile index results demonstrated that there is significant inequity in Shanghai's EMS, primarily driven by the disparity in accessibility between central and suburban districts. The results based on the MCR model indicated that the EMS stations in central districts had smaller shortest-time service areas, fewer resource demands, and lower PRTs. Obtained results revealed that EMS accessibility in Shanghai exhibited clear spatiotemporal variation, driven by disparities across urban districts and multi-period traffic conditions. Additionally, the irrational layout of EMS stations exacerbated the equity and opportunity to EMS services for citizens in suburban districts of Shanghai.
紧急医疗服务（EMS）是公共医疗保健的重要组成部分。本研究旨在精确测量上海市紧急医疗服务的时空可达性和公平性。我们构建了一个结合网络地图应用程序编程接口（API）和经验贝叶斯克里金（EBK）插值方法的研究模型来计算紧急医疗服务可达性，并使用泰尔指数评估紧急医疗服务可达性的公平性。此外，我们使用最小累积阻力（MCR）模型评估急救站点布局的合理性。结果表明，上海市的人均响应时间（PRT）在交通顺畅时段从11.46分钟增加到交通高峰期的13.08分钟，12分钟紧急医疗服务可达性（EAI）人口覆盖率从60.6%降至41.9%。泰尔指数结果表明，上海市紧急医疗服务存在显著不公平性，主要是由中心城区和郊区可达性的差异所致。基于MCR模型的结果表明，中心城区的急救站点最短服务时间区域较小、资源需求较少且人均响应时间较低。研究结果表明，上海市紧急医疗服务可达性呈现出明显的时空变化，这是由城区差异和多时段交通状况造成的。此外，急救站点布局不合理加剧了上海市郊区居民获得紧急医疗服务的公平性和机会问题。
