ArticleBMJ open2020
Assessing inequalities in geographical access to emergency medical services in metropolitan Lisbon: a cross-sectional and ecological study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Geospatial Insights into Healthcare Accessibility in Europe: A Scoping Review of GIS Applications.Healthcare (Basel, Switzerland) · 2025Review
- Measuring spatiotemporal accessibility and equity of emergency medical services in Shanghai, China.PloS one · 2025Article
- A multicriteria vulnerability index for equitable resource allocation in public health funding.Canadian journal of public health = Revue canadienne de sante publique · 2024Article
- Ambulance service recognition of health inequalities and activities for reduction: An evidence and gap map of the published literature.British paramedic journal · 2024Article
- Prehospital Time Interval for Urban and Rural Emergency Medical Services: A Systematic Literature Review.Healthcare (Basel, Switzerland) · 2022Review
- Spatial accessibility of emergency medical services in Chongqing, Southwest China.Frontiers in public health · 2022Article
- Socio-spatial disparities in access to emergency health care-A Scandinavian case study.PloS one · 2021Article
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Authors and funding
2 authors.
Funding
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Abstract
objectivesStudies have suggested that material deprivation is strongly associated with negative health outcomes, and lower usage of various levels of healthcare. We aim to analyse geographical access to emergency medical services (EMSs) and hospital emergency units by EMS in relation to deprivation in the Lisbon Metropolitan Area (LMA), Portugal.
designThis study estimates road network-based access times from the centroids of statistical sections (census block groups equivalent) to locations of EMS and hospital emergency services. Each statistical section has been linked to a Material Deprivation Index (MDI). A non-parametric analysis of variance (ANOVA) was undertaken to compare MDI-linked statistical sections in terms of access to emergency care. Geographical access analysis was conducted for 2018. PRIMARY OUTCOME MEASURE: Road network-based access time (in minutes) for EMSs to statistical sections and then on to emergency units in hospitals.
resultsOverall, 82.4% of the LMA population is located less than a 10 min drive from an EMS without transport, and 99.1% from an EMS with transport. Travel time from EMS with transport to hospital is potentially less than 20 min for 95.2% of the population. However, 63.1% of residents living beyond a 30 min threshold (total time from emergency call to hospital arrival) are in areas with very high MDI (18.8% in high MDI, 13.3% in medium MDI, 4.7% in low MDI, 0% in very low MDI). Kruskal-Wallis ANOVA confirms discrepancies in access times between better-off and poorer areas.
conclusionPoorer areas experience worse geographical access to EMS and hospital emergency units. More research is needed to explore the quality of services and their outcomes, and to refine the analysis by focusing on specific vulnerable groups.
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