ArticleInternational journal for equity in health2017
Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.
Article in International journal for equity in health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Barriers to Trauma Care in South and Central America: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Pooled it
- Physical Activity Behavior and Acute Myocardial Infarction, Stroke, and Sepsis Outcomes in Brazil: Insights from Targeted Eigenvector Centrality Networks.International journal of environmental research and public health · 2026Article
- Time-series trends and regional disparities in complete denture production in Brazil (2000-2023): an epidemiological analysis.Journal of applied oral science : revista FOB · 2026Article
- Data Innovation, Program Implementation, and Community Action (DIPICA) Observatory for Surgical, Anesthesia, and Obstetric (SAO) Care in India.BMC proceedings · 2025Article
- A Survey on Digital Solutions for Health Services Management: Features and Use Cases from Brazilian National Literature.Healthcare (Basel, Switzerland) · 2025Review
- Determinants of surgical approach to pediatric appendicitis in Brazil.Pediatric surgery international · 2025Article
- The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System.The International journal of health planning and management · 2025Review
- Geographic inequalities and factors associated with unfavorable outcomes in diabetes-tuberculosis and diabetes-covid comorbidities in Brazil.Scientific reports · 2025Article
- Geographic disparities and temporal trends regarding access to cancer treatment: a spatial analysis, Brazil, 2015-2022.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- Inequalities in the geographic access to delivery services in Brazil.BMC health services research · 2024Article
- Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil.World journal of pediatric surgery · 2023Article
- Article
- Emergency Care Sensitive Conditions in Brazil: A Geographic Information System Approach to Timely Hospital Access.Lancet regional health. Americas · 2021Article
- Geographic barriers to establishing a successful hospital referral system in rural Madagascar.BMJ global health · 2021Article
- Review
- Article
- Socio-spatial disparities in access to emergency health care-A Scandinavian case study.PloS one · 2021Article
- Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach.PloS one · 2020Article
- Temporal Delays Along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients at a Tertiary Care Hospital in Kampala, Uganda.Neurosurgery · 2019Article
- Methodology for building a geographical accessibility health index throughout metropolitan France.PloS one · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges.
methodsThe present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals.
resultsThe analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people.
conclusionsThere is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access to emergency and surgical care. However more investments in are necessary to improve small hospitals capabilities to fill this gap.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.