Measuring and optimizing spatial accessibility to emergency medical services with a focus on age-based spatial...

Area of Science:

• Public Health
• Spatial Analysis
• Health Services Research

Background:

• Emergency Medical Services (EMS) are vital for public health, but their effectiveness relies on spatial accessibility and optimal facility placement.
• Current EMS accessibility assessments often use general population data, neglecting variations in risk across different spatial areas and age demographics.
• This gap highlights the need for more nuanced methods to measure and optimize EMS accessibility.

Purpose of the Study:

• To develop an improved framework for measuring EMS spatial accessibility and optimizing facility locations.
• To integrate spatial and demographic variations in EMS risk into accessibility models.
• To compare the outcomes of risk-integrated models with traditional approaches.

Main Methods:

• Developed an integrated framework combining a modified two-step floating catchment area (2SFCA) model with spatial optimization models (Maximum Covering Location Problem and P-median).
• Incorporated spatial and age-based EMS risk data derived from EMS records in Wuhan, China.
• Conducted comparative analyses between traditional and risk-integrated models.

Main Results:

• Identified significant age-related and spatial variations in EMS risk, with older adults facing higher risks and high-risk zones concentrated in central and near-suburban districts.
• Risk-integrated models revealed substantially different accessibility distributions compared to traditional 2SFCA, especially in peri-urban areas.
• Optimized EMS station locations using risk-integrated models prioritized near-urban areas, unlike traditional models that favored peripheral suburbs.

Conclusions:

• Integrating spatial and demographic risk variations significantly enhances the accuracy of EMS accessibility measurement and optimization.
• Prioritizing high-risk older adult populations and strengthening EMS capacity in urban cores and underserved suburbs are crucial for equitable systems.
• The proposed framework provides a transferable tool for developing more efficient and equitable EMS systems in rapidly urbanizing and aging regions.