Geographical and Population Disparities in Timely Access to Prehospital and Advanced Level Emergency Care in New Zealand: A Cross-sectional Study

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aut.relation.articlenumbere026026en_NZ
aut.relation.issue7en_NZ
aut.relation.journalBMJ Openen_NZ
aut.relation.volume9en_NZ
aut.researcherDicker, Bridget
dc.contributor.authorLilley, Ren_NZ
dc.contributor.authorde Graaf, Ben_NZ
dc.contributor.authorKool, Ben_NZ
dc.contributor.authorDavie, Gen_NZ
dc.contributor.authorReid, Pen_NZ
dc.contributor.authorDicker, Ben_NZ
dc.contributor.authorCivil, Ien_NZ
dc.contributor.authorAmeratunga, Sen_NZ
dc.contributor.authorBranas, Cen_NZ
dc.date.accessioned2020-07-14T04:39:53Z
dc.date.available2020-07-14T04:39:53Z
dc.date.copyright2019en_NZ
dc.date.issued2019en_NZ
dc.description.abstractObjective Rapid access to advanced emergency medical and trauma care has been shown to significantly reduce mortality and disability. This study aims to systematically examine geographical access to prehospital care provided by emergency medical services (EMS) and advanced-level hospital care, for the smallest geographical units used in New Zealand and explores national disparities in geographical access to these services. Design Observational study involving geospatial analysis estimating population access to EMS and advanced-level hospital care. Setting Population access to advanced-level hospital care via road and air EMS across New Zealand. Participants New Zealand population usually resident within geographical census meshblocks. Primary and secondary outcome measures The proportion of the resident population with calculated EMS access to advanced-level hospital care within 60 min was examined by age, sex, ethnicity, level of deprivation and population density to identify disparities in geographical access. Results An estimated 16% of the New Zealand population does not have timely EMS access to advanced-level hospital care via road or air. The 700 000 New Zealanders without timely access lived mostly in areas of low-moderate population density. Indigenous Māori, New Zealand European and older New Zealanders were less likely to have timely access. Conclusions These findings suggest that in New Zealand, geographically marginalised groups which tend to be rural and remote communities with disproportionately more indigenous Māori and older adults have poorer EMS access to advanced-level hospitals. Addressing these inequities in rapid access to medical care may lead to improvements in survival that have been documented for people who experience medical or surgical emergencies.en_NZ
dc.identifier.citationBMJ Open 2019;9:e026026. doi: 10.1136/bmjopen-2018-026026
dc.identifier.doi10.1136/bmjopen-2018-026026en_NZ
dc.identifier.issn2044-6055en_NZ
dc.identifier.issn2044-6055en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/13529
dc.languageenen_NZ
dc.publisherBMJen_NZ
dc.relation.urihttps://bmjopen.bmj.com/content/9/7/e026026
dc.rightsThis is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.rights.accessrightsOpenAccessen_NZ
dc.titleGeographical and Population Disparities in Timely Access to Prehospital and Advanced Level Emergency Care in New Zealand: A Cross-sectional Studyen_NZ
dc.typeJournal Article
pubs.elements-id362558
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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