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Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city.

dc.contributor.author Jiang, Y
dc.contributor.author Liu, Y
dc.contributor.author Qiu, J
dc.contributor.author Tang, Shenglan
dc.contributor.author Wang, Y
dc.contributor.author Zhong, X
dc.coverage.spatial England
dc.date.accessioned 2017-12-01T14:20:46Z
dc.date.available 2017-12-01T14:20:46Z
dc.date.issued 2015-12-21
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/26689717
dc.identifier 10.1186/s12939-015-0282-8
dc.identifier.uri http://hdl.handle.net/10161/15798
dc.description.abstract BACKGROUND: Due to reform of the economic system and the even distribution of available wealth, emergency medical services (EMS) experienced greater risks in equity. This study aimed to assess the equity of EMS needs, utilisation, and distribution of related resources, and to provide evidence for policy-makers to improve such services in Chongqing city, China. METHODS: Five emergency needs variables (mortality rate of maternal, neonatal, cerebrovascular, cardiovascular, injury and poisoning) from the death surveillance, and two utilisation variables (emergency room visits and rate of utilisation) were collected from Chongqing Health Statistical Year Book 2008 to 2012. We used a concentration index (CI) to assess equality in the distribution of needs and utilisation among three areas with different per-head gross domestic product (GDP). In each area, we randomly chose two districts as sample areas and selected all the medical institutions with emergency services as subjects. We used the Gini coefficient (G) to measure equity in population and geographic distribution of facilities and human resources related EMS. RESULTS: Maternal-caused (CI: range -0.213 to -0.096) and neonatal-caused (CI: range -0.161 to -0.046)deaths declined in 2008-12, which focusing mainly on the less developed area. The maternal deaths were less equitably distributed than neonatal, and the gaps between areas gradually become more noticeable. For cerebrovascular (CI: range 0.106 to 0.455), cardiovascular (CI: range 0.101 to 0.329), injury and poisoning (CI: range 0.001 to 0.301) deaths, we documented a steady improvement of mortality; the overall equity of these mortalities was lower than those of maternal and neonatal mortalities, but distinct decreases were seen over time. The patients in developed area were more likely to use EMS (CI: range 0.296 to 0.423) than those in less developed area, and the CI increased over the 5-year period, suggesting that gaps in equity were increasing. The population distribution of facilities, physicians and nurses (G: range 0.2 to 0.3) was relatively equitable; the geographic distribution (G: range 0.4 to 0.5) showed a big gap between areas. CONCLUSIONS: In Chongqing city, equity of needs, utilization, and resources allocation of EMS is low, and the provision of such services has not met the needs of patients. To narrow the gap of equity, improvement in the capability of EMS to decrease cerebrovascular, cardiovascular, injury and poisoning cases, should be regarded as a top priority. In poor areas, allocation of facilities and human resources needs to be improved, and the economy should also be enhanced.
dc.language eng
dc.relation.ispartof Int J Equity Health
dc.relation.isversionof 10.1186/s12939-015-0282-8
dc.subject China
dc.subject Cross-Sectional Studies
dc.subject Emergency Medical Services
dc.subject Female
dc.subject Health Equity
dc.subject Health Services Accessibility
dc.subject Humans
dc.subject Infant
dc.subject Infant Mortality
dc.subject Male
dc.subject Maternal Health Services
dc.subject Maternal Mortality
dc.subject Pregnancy
dc.subject Socioeconomic Factors
dc.subject Surveys and Questionnaires
dc.title Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/26689717
pubs.begin-page 150
pubs.organisational-group Basic Science Departments
pubs.organisational-group Duke
pubs.organisational-group Population Health Sciences
pubs.organisational-group School of Medicine
pubs.organisational-group Temp group - logins allowed
pubs.publication-status Published online
pubs.volume 14
dc.identifier.eissn 1475-9276


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