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Distribution and Accessibility of Hospital-Based Emergency Departments for Paediatric Patients in Rural and Remote
Hanin Bakhaider1,2, Somayyeh Azimi2, Marc Tennant2
1Paediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Insights
Emergency department access in Western Australia varies by remoteness and socioeconomic status. Service planning should prioritize areas with the greatest access shortfalls, considering both proximity and capacity for children.
Area of Science:
- Public Health
- Spatial Analysis
- Healthcare Access
Background:
- Emergency department (ED) distribution and service availability are critical for child healthcare.
- Understanding geographic and socioeconomic disparities in ED access is essential for equitable healthcare planning.
Purpose of the Study:
- To examine the spatial distribution of emergency departments in non-metropolitan Western Australia.
- To assess emergency service availability for children relative to remoteness and socioeconomic disadvantage.
Main Methods:
- Spatial analysis using Australian Government datasets, integrating child population and facility locations.
- Classification by remoteness (Modified Monash Model - MMM) and socioeconomic disadvantage (Index of Relative Socioeconomic Disadvantage - IRSD).
- Quantified child proximity using buffer zones and assessed service availability via facility-to-child and bed-to-child ratios.
Main Results:
- ED availability decreased with increasing remoteness (MMM5, MMM6, MMM7).
- Facility-to-child and bed-to-child ratios appeared more favorable in very remote areas due to lower population density.
- Facilities and bed capacity were concentrated in the most disadvantaged areas (IRSD 1).
Conclusions:
- Persistent geographic and socioeconomic inequities exist in paediatric emergency care across rural and remote Western Australia.
- Favorable ratios in remote areas reflect low population, not increased investment.
- Needs-based planning using remoteness and IRSD-stratified measures is recommended to address access shortfalls.
Objective:
This study examined the distribution of emergency departments relative to remoteness and socioeconomic disadvantage and explored service availability for children in non-metropolitan Western Australia.
Methods:
We conducted a spatial analysis using the Australian Government datasets. Child population counts and emergency facility locations were integrated into Quantum Geographic Information System and classified by remoteness using the Modified Monash Model (MMM) and by area-level socioeconomic disadvantage using the Index of Relative Socioeconomic Disadvantage (IRSD). Buffer zones were generated around each facility to quantify the proportion of children residing within specified distance thresholds. Service availability was assessed using facility-to-child and bed-to-child ratios.
Results:
Emergency department availability declined with increasing remoteness: MMM5 contained the largest share of facilities (42.6%), followed by MMM6 (31.2%) and MMM7 (26.2%). However, ratios appeared more favourable in very remote areas, with facility-to-child ratios improving from 1:848 (MMM5) to 1:741 (MMM7). Bed availability showed a similar pattern, ranging from 1:83 in MMM5 to 1:60 in MMM7. Socioeconomic analyses revealed a concentration of facilities and bed capacity in the most disadvantaged areas, with IRSD 1 hosting 57.4% of all facilities and 35.8% of total bed capacity.
Conclusion:
Geographic and socioeconomic inequities in emergency care provision persist across rural and remote Western Australia. Apparent improvements in ratios in very remote areas are driven by low population density rather than greater service investment. These findings support a shift to needs-based paediatric emergency service planning, using remoteness and IRSD-stratified proximity and capacity measures to prioritise communities with the greatest access shortfalls.
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