Factors Influencing the Emergency Medical Service Response Time for Cardiovascular Disease in Guangzhou, China

Xiao-qian Chen, Zi-feng Liu, Shi-kun Zhong, Xing-tang Niu, Yi-xiang Huang, Ling-ling Zhang

Current Medical Science ›› 2019, Vol. 39 ›› Issue (3) : 463-471.

Current Medical Science ›› 2019, Vol. 39 ›› Issue (3) : 463-471. DOI: 10.1007/s11596-019-2061-z
Article

Factors Influencing the Emergency Medical Service Response Time for Cardiovascular Disease in Guangzhou, China

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Abstract

While emergency medical service (EMS) response time (ERT) is a major factor associated with the survival of patients with cardiovascular disease (CVD), relatively few studies have explored the factors associated with ERT. This study aimed to assess the current status of ERT and to identify the factors affecting ERT in patients with CVD in China. Between January 1, 2011 and December 31, 2015, EMS responses to CVD incidents in Guangzhou, China, were examined. The primary outcome was ERT, defined as the time from receipt of an emergency call to the arrival of paramedics on the scene. Factors associated with ERT were evaluated by multivariable logistic regression. A total of 44 383 CVD incidents were analysed. The median ERT was 12.58 min (interquartile range=9.98–15.67). Among the risk factors, distance (OR=13.73, 95% CI=11.76–16.04), level of hospital (OR=1.57, 95% CI=1.40–1.75), and site of the incident (OR=1.53, 95% CI=1.38–1.69) were the top three significant factors affecting the ERT. Our results suggest that greater attention should be given to factors affecting the ERT. It is essential to make continuous efforts to promote the development of effective interventions to reduce the response time.

Keywords

emergency medical service / cardiovascular disease / response time / factors / China

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Xiao-qian Chen, Zi-feng Liu, Shi-kun Zhong, Xing-tang Niu, Yi-xiang Huang, Ling-ling Zhang. Factors Influencing the Emergency Medical Service Response Time for Cardiovascular Disease in Guangzhou, China. Current Medical Science, 2019, 39(3): 463‒471 https://doi.org/10.1007/s11596-019-2061-z

References

[1]
ValenzuelaTD, RoeDJ, NicholG, et al.. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med, 2000, 343(17): 1206-1209
CrossRef Google scholar
[2]
XiB, LiuF, HaoY, et al.. The growing burden of cardiovascular diseases in China. Int J Cardiol, 2014, 174(3): 736-737
CrossRef Google scholar
[3]
McLayLA, MayorgaME. Evaluating emergency medical service performance measures. Health Care Manag Sci, 2010, 13(2): 124-136
CrossRef Google scholar
[4]
WildeET. Do emergency medical system response times matter for health outcomes?. Health Econ, 2013, 22(7): 790-806
CrossRef Google scholar
[5]
DoYK, FooK, NgYY, et al.. A quantile regression analysis of ambulance response time. Prehosp Emerg Care, 2013, 17(2): 170-176
CrossRef Google scholar
[6]
AustinPC, SchullMJ. Quantile regression: a statistical tool for out-of-hospital research. Acad Emerg Med, 2003, 10(7): 789-797
CrossRef Google scholar
[7]
NehmeZ, AndrewE, SmithK. Factors Influencing the Timeliness of Emergency Medical Service Response to Time Critical Emergencies. Prehosp Emerg Care, 2016, 20(6): 783-791
CrossRef Google scholar
[8]
MoserDK, KimbleLP, AlbertsMJ, et al.. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation, 2006, 114(2): 168-182
CrossRef Google scholar
[9]
Bureau of Health in Guangzhou.. Health Statistics Yearbook in Guangzhou, 2017, Guangzhou, China, Guangdong Provincial Press
[10]
JauchEC, SaverJL, AdamsHPJr., et al.. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2013, 44(3): 870-947
CrossRef Google scholar
[11]
General Office of the State Council of the People’s Republic of China. Notice of the General Office of the State Council on Forwarding the Construction Plan for the Emergency Medical Emergency Treatment System of the Mnistry of Health of the National Development and Reform Commission [EB/OL]. (2003-09-29)[2018-05-18].http://www.gov.cn/zhengce/content/2008-03/28/content_6332.htm
[12]
BreenN, WoodsJ, BuryG, et al.. A national census of ambulance response times to emergency calls in Ireland. J Accid Emerg Med, 2000, 17(6): 392-395
CrossRef Google scholar
[13]
OttesenMM, DixenU, Torp-PedersenC, et al.. Prehospital delay in acute coronary syndrome—an analysis of the components of delay. Int J Cardiol, 2004, 96(1): 97-103
CrossRef Google scholar
[14]
DracupK, MoserDK. Beyond sociodemographics: factors influencing the decision to seek treatment for symptoms of acute myocardial infarction. Heart Lung, 1997, 26(4): 253-262
CrossRef Google scholar
[15]
MorrisonLJ, AngeliniMP, VermeulenMJ, et al.. Measuring the EMS patient access time interval and the impact of responding to high-rise buildings. Prehosp Emerg Care, 2005, 9(1): 14-18
CrossRef Google scholar
[16]
LateefF, AnantharamanV. Delays in the EMS response to and the evacuation of patients in high-rise buildings in Singapore. Prehosp Emerg Care, 2000, 4(4): 327-332
CrossRef Google scholar
[17]
VanderBurghD, JamiesonR, BeardyJ, et al.. Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community. Rural Remote Health, 2014, 14: 2537
[18]
LaiH, ChoongCV, Fook-ChongS, et al.. Interventional strategies associated with improvements in survival for out-of-hospital cardiac arrests in Singapore over 10 years. Resuscitation, 2015, 89: 155-161
CrossRef Google scholar
[19]
LamSS, NguyenFN, NgYY, et al.. Factors affecting the ambulance response times of trauma incidents in Singapore. Accid Anal Prev, 2015, 82: 27-35
CrossRef Google scholar
[20]
HeSY, Th/ıgersenJ. The impact of attitudes and perceptions on travel mode choice and car ownership in a Chinese megacity: The case of Guangzhou. Res Transp Econ, 2017, 62: 57-67
CrossRef Google scholar
[21]
Wei LamSS, ZhangZC, OhHC, et al.. Reducing ambulance response times using discrete event simulation. Prehosp Emerg Care, 2014, 18(2): 207-216
CrossRef Google scholar
[22]
LamSS, ZhangJ, ZhangZC, et al.. Dynamic ambulance reallocation for the reduction of ambulance response times using system status management. Am J Emerg Med, 2015, 33(2): 159-166
CrossRef Google scholar
[23]
NakstadAR, BjellandB, SandbergM. Medical emergency motorcycle—is it useful in a Scandinavian Emergency Medical Service?. Scand J Trauma Resusc Emerg Med, 2009, 17: 9
CrossRef Google scholar
[24]
Soares-OliveiraM, EgiptoP, CostaI, et al.. Emergency motorcycle: has it a place in a medical emergency system?. Am J Emerg Med, 2007, 25(6): 620-622
CrossRef Google scholar
[25]
MoserDK, McKinleyS, DracupK, et al.. Gender differences in reasons patients delay in seeking treatment for acute myocardial infarction symptoms. Patient Educ Couns, 2005, 56(1): 45-54
CrossRef Google scholar
[26]
SheiferSE, RathoreSS, GershBJ, et al.. Time to presentation with acute myocardial infarction in the elderly: associations with race, sex, and socioeconomic characteristics. Circulation, 2000, 102(14): 1651-1656
CrossRef Google scholar
[27]
GartnerC, WalzL, BauernschmittE, et al.. The causes of prehospital delay in myocardial infarction. Dtsch Arztebl Int, 2008, 105(15): 286-291
[28]
LadwigKH, MeisingerC, HymerH, et al.. Sex and age specific time patterns and long term time trends of pre-hospital delay of patients presenting with acute ST-segment elevation myocardial infarction. Int J Cardiol, 2011, 152(3): 350-355
CrossRef Google scholar
[29]
KeyCB. Operational issues in EMS. Emerg Med Clin N Am, 2002, 20(4): 913-927
CrossRef Google scholar
[30]
PelegK, PliskinJS. A geographic information system simulation model of EMS: reducing ambulance response time. Am J Emerg Med, 2004, 22(3): 164-170
CrossRef Google scholar
[31]
HodgettsTJ, BrownT, DriscollP, et al.. Pre-hospital cardiac arrest: room for improvement. Resuscitation, 1995, 29(1): 47-54
CrossRef Google scholar
[32]
MullieA, Van HoeyweghenR, QuetsA, et al.. Influence of time intervals on outcome of CPR. Resuscitation, 1989, 17: S23-S33
CrossRef Google scholar
[33]
SilvermanRA, GaleaS, BlaneyS, et al.. The “vertical response time”: barriers to ambulance response in an urban area. Acad Emerg Med, 2007, 14(9): 772-778
[34]
PonsPT, HaukoosJS, BludworthW, et al.. Paramedic response time: does it affect patient survival?. Acad Emerg Med, 2005, 12(7): 594-600
CrossRef Google scholar
[35]
TanigawaK, TanakaK. Emergency medical service systems in Japan: past, present, and future. Resuscitation, 2006, 69(3): 365-370
CrossRef Google scholar
[36]
MarkelDT, GoldLS, FahrenbruchCE, et al.. Prompt advanced life support improves survival from ventricular fibrillation. Prehosp Emerg Care, 2009, 13(3): 329-334
CrossRef Google scholar

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