Factors affecting the ambulance response times of trauma incidents in Singapore
Factors affecting the ambulance response times of trauma incidents in Singapore
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DOI：
10.1016/j.aap.2015.05.007
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发表时间：
2015-09-01
影响因子：
5.9
通讯作者：
Ong, Marcus Eng Hock
中科院分区：
文献类型：
--
作者：
Lam, Sean Shao Wei;Nguyen, Francis Ngoc Hoang Long;Ong, Marcus Eng Hock
目的：到最终护理的时间对于创伤结果是重要的，因此世界上许多紧急医疗服务（EMS）系统采用救护车的响应时间作为关键性能指标。本研究的目的是探讨潜在的风险因素，可以影响救护车响应时间（ART）的创伤事件，从而得出干预措施，可以提高ART。材料和方法：这是一项回顾性研究的基础上两年的创伤数据从新加坡的国家EMS运营中心。纳入了2011年1月1日至2012年12月31日期间由国家EMS供应商提供服务的创伤患者。ART被归类为“短”（8分钟）响应时间。一个建模框架，利用多项逻辑（MNL）回归模型和贝叶斯网络提出了识别的主要和相互作用effects.Results：在过程相关的风险因素，天气，交通和事件发生的地方被发现是显着的。交通状况对ART的影响最大，交通繁忙时长ART的OR值是交通繁忙时的12.98倍（95% CI：10.66-15.79）。此外，“大雨”条件下“长ART”的OR值显著高于“晴好”条件下的OR值（OR 1.58，95% CI：1.26-1.97）。在考虑混杂因素后，“长时间”ART在“家庭”或“商业”地点发生的创伤事件的OR也显著高于“道路”事件。交通，天气和事件发生的地点被认为是显着的影响ART。影响ART的因素的评估，使发展有效的干预措施，以减少ART。（C）2015爱思唯尔有限公司版权所有。
Objectives: Time to definitive care is important for trauma outcomes, thus many emergency medical services (EMS) systems in the world adopt response times of ambulances as a key performance indicator. The objective of this study is to examine the underlying risk factors that can affect ambulance response times (ART) for trauma incidents, so as to derive interventional measures that can improve the ART.Material and methods: This was a retrospective study based on two years of trauma data obtained from the national EMS operations centre of Singapore. Trauma patients served by the national EMS provider over the period from 1 January 2011 till 31 December 2012 were included. ART was categorized into "Short" (8 min) response times. A modelling framework which leveraged on both multinomial logistic (MNL) regression models and Bayesian networks was proposed for the identification of main and interaction effects.Results: Amongst the process-related risk factors, weather, traffic and place of incident were found to be significant. The traffic conditions on the roads were found to have the largest effect the odds ratio (OR) of "Long" ART in heavy traffic condition was 12.98 (95% CI: 10.66-15.79) times higher than that under light traffic conditions. In addition, the ORs of "Long ART" under "Heavy Rain" condition were significantly higher (OR 1.58, 95% CI: 1.26-1.97) than calls responded under "Fine" weather. After accounting for confounders, the ORs of "Long" ART for trauma incidents at "Home" or "Commercial" locations were also significantly higher than that for "Road" incidents.Conclusion: Traffic, weather and the place of incident were found to be significant in affecting the ART. The evaluation of factors affecting the ART enables the development of effective interventions for reducing the ART. (C) 2015 Elsevier Ltd. All rights reserved.