Does ambulance utilization differ between urban and rural regions: a study of 112 services in a populated city- Izmir

Abstract

Objective Emergency Medical Services (EMS) play an important role in health care systems especially when well planned and well managed. The goal of this research was to characterize ambulance utilization rates and investigate associated factors. Such an analysis could make a contribution to operational planning of these services. Materials and methods The data for this study were taken from the Izmir emergency ambulance service known as the 112 service because of its call number. Total emergency demand made during 2013 was analyzed and the data were categorized according to four sub-categories: gender age rural-urban and reason for the call. For each category an analysis was made in terms of the absolute number of calls and a relative measure. Hypothesis testing and correlation analysis were used to investigate the differences between the demand for each category and to compare demand across categories. Results Although demand rates from males and females were very similar a significant difference was observed in the daily utilization of these services by gender. The absolute number of calls from rural regions was less than for urban regions but the rural regions had a higher proportion of calls (i.e. calls per 1000 people). Similarly the absolute number of calls generated by the elderly was less than that generated by the young but the elderly had a higher value in terms of relative measures. A medical condition was the most frequent reason for calls. A significant and positive relation was observed between male-female and elderly-young citizens and there was a significant but negative relation between rural-urban demand. Conclusion This study confirms that gender age and rural-urban distinctions are major factors that affect demand for these services and should therefore to be taken into consideration in operations management. It also highlights the need for a specific focus on rural regions and elderly citizens.