Factors affecting the ambulance response times of trauma incidents in Singapore |
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| Affiliation: | 1. Health Services Research and Biostatistics Unit, Division of Research, Singapore General Hospital, 226 Outram Road, Singapore 169039, Singapore;2. Medical Department, Singapore Civil Defence Force, 91 Ubi Ave 4, Singapore 408827, Singapore;3. Health Services Research and Biostatistics Unit, Division of Research, Singapore General Hospital, 226 Outram Road, Singapore 169039, Singapore;4. Department of General Surgery, Singapore General Hospital; Health Services Research and Biostatistics Unit, Division of Research, Singapore General Hospital, 226 Outram Road, Singapore 169039, Singapore;5. Health Services Research and Biostatistics Unit, Division of Research, Singapore General Hospital, 226 Outram Road, Singapore 169039, Singapore;6. Department of Emergency Medicine, Singapore General Hospital; Health Services Research and Biostatistics Unit, Division of Research, Singapore General Hospital; Health Services and Systems Research, Duke-NUS Graduate Medical School, 226 Outram Road, Singapore 169039, Singapore;1. Department of Economics, Karlstad University, Karlstad, Sweden;2. Emergency Medical Institute Thailand, Bangkok, Thailand;1. College of Management, Shenzhen University, Shenzhen, China;2. School of Economics and Management, Tongji University, Shanghai, China;3. School of Business Planning, Chongqing Technology and Business University, Chongqing, China;1. Centrum Wiskunde & Informatica, Science Park 123, 1098XG, Amsterdam, The Netherlands;2. Vrije Universiteit Amsterdam, De Boelelaan 1081a, 1081HV, Amsterdam, The Netherlands;1. Lahore University of Management Sciences, Sector U, DHA Lahore 54792, Pakistan;2. Francis Marion University, 4822 E Palmetto St, Florence, SC 29506, United States;3. University of North Carolina-Charlotte, 9201 University City Blvd, Charlotte, NC 28262, United States;4. North Carolina State University, 400 Daniels Hall, Raleigh, NC 27695, United States |
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| Abstract: | ObjectivesTime 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 methodsThis 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” (<4 min), “Intermediate” (4–8 min) and “Long” (>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.ResultsAmongst 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.ConclusionTraffic, 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. |
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| Keywords: | Emergency medical services Ambulance response time Trauma Multinomial logistic regression |
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