ArticlePloS one2021
Travel time to emergency care not by geographic time, but by optimal time: A nationwide cross-sectional study for establishing optimal hospital access time to emergency medical care in South Korea.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Association Between Community-Level Social Determinants of Health and Sepsis Incidence and Mortality: A Scoping Review.Critical care explorations · 2026Article
- Examining the association between spatial accessibility to emergency cardiac care centers and cardiovascular mortality in Georgia, United States.BMC cardiovascular disorders · 2026Article
- Optimizing Territorial Healthcare Networks with a Capacity-Constrained Hub-And-Spoke Allocation Algorithm: The Province of L'Aquila Case Study.Healthcare (Basel, Switzerland) · 2026Article
- Travel Distance to Dialysis and Mortality Among Hemodialysis Patients in a Geographically Small Country.Journal of community health · 2025Article
- A global map of travel time to access veterinarians.Nature communications · 2025Article
- Intentional transit practice through a nearby hospital for remote area emergencies provides earlier primary care than helicopter emergency medical services alone in rural emergencies: a single-center, observational study.Journal of rural medicine : JRM · 2025Article
- Tackling Cardiovascular Care Deserts in Romania: Expanding Population Access in Underserved Areas.Healthcare (Basel, Switzerland) · 2024Article
- High-Volume Hospital Had Lower Mortality of Severe Intracerebral Hemorrhage Patients.Journal of Korean Neurosurgical Society · 2024Article
- Long-term exposure to PMBMC public health · 2024Article
- Timely accessibility to healthcare resources and heatwave-related mortality in 7 major cities of South Korea: a two-stage approach with principal component analysis.The Lancet regional health. Western Pacific · 2024Article
- Trends in emergency department visits for emergency care-sensitive conditions before and during the COVID-19 pandemic: a nationwide study in Korea, 2019-2021.Clinical and experimental emergency medicine · 2024Article
- The Relationship between Hospital Selection by Employer and Disabilities in Occupational Accidents in Korea.Safety and health at work · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Increase in travel time, beyond a critical point, to emergency care may lead to a residential disparity in the outcome of patients with acute conditions. However, few studies have evaluated the evidence of travel time benchmarks in view of the association between travel time and outcome. Thus, this study aimed to establish the optimal hospital access time (OHAT) for emergency care in South Korea. We used nationwide healthcare claims data collected by the National Health Insurance System database of South Korea. Claims data of 445,548 patients who had visited emergency centers between January 1, 2006 and December 31, 2014 were analyzed. Travel time, by vehicle from the residence of the patient, to the emergency center was calculated. Thirteen emergency care-sensitive conditions (ECSCs) were selected by a multidisciplinary expert panel. The 30-day mortality after discharge was set as the outcome measure of emergency care. A change-point analysis was performed to identify the threshold where the mortality of ECSCs changed significantly. The differences in risk-adjusted mortality between patients living outside of OHAT and those living inside OHAT were evaluated. Five ECSCs showed a significant threshold where the mortality changed according to their OHAT. These were intracranial injury, acute myocardial infarction, other acute ischemic heart disease, fracture of the femur, and sepsis. The calculated OHAT were 71-80 min, 31-40 min, 70-80 min, 41-50 min, and 61-70 min, respectively. Those who lived outside the OHAT had higher risks of death, even after adjustment (adjusted OR: 1.04-7.21; 95% CI: 1.03-26.34). In conclusion, the OHAT for emergency care with no significant increase in mortality is in the 31-80 min range. Optimal travel time to hospital should be established by optimal time for outcomes, and not by geographic time, to resolve the disparities in geographical accessibility to emergency care.
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