1. Access to emergency hospitals
A GEOSTAT 1B case study
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

2. GISCO - WORKING PARTY MEETING,
Aim and relevance
Aim:
To demonstrate the advantages of grid statistics
To analyse the population’s geographical access to emergency hospitals divided by age-groups and sex
Relevance:
A potential complement to The European Core Health Indicators (ECHI) indicator 80: Equity of access to health care services
May result in improved understanding of ECHI survey results
Can improve existing surveys
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

3. Emergency Medical Services
Emergency Medical Services (EMS)
include Emergency Hospitals and pre-hospital care (on-site care and transport)
vary in between countries
Emergency Hospitals (EH)
Can have an important role in the pre-hospital care as a center for ambulance vehicles, staff and communication
Figure 1. An example of an EMS framework
GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014

4. Partners’ understanding of EH
The partners have defined emergency hospitals as a medical care center handling so called in-patience. That will say hospitals that can have patience overnight. Bulgaria has also included ambulance services and is therefore not comparable.
Czech Republic
136 hospitals with intensive care units and internal or cardiology departments. Selected out of 184 hospitals with beds for acute care (excluding narrowly specialized or detached establishments)
Estonia
19 hospitals providing emergency care (included in the Estonian “Hospital Master Plan” and not ambulance stations)
Finland
56 hospitals’ and health centres’ emergency rooms with 24/7 service (excluding “mobile emergency rooms” in the northern part of Finland)
Norway
44 hospitals with emergency rooms (excluding pre-hospital services as ambulance services, emergency medical communication centres and emergency clinics “legevakt”)
Bulgaria
28 Centers for Emergency Health Care and regional branches in the smaller towns (in most cases the municipality centers) including medical teams with equipped vehicles
GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014

5. GISCO - WORKING PARTY MEETING,
Methodology
Data used:
Emergency hospitals
1km x 1km grids and municipalities including population data divided by age groups and sex
Road network including information about speed limits
Process:
1. Establish a map with service areas based on 30-minute travelling distances from or to emergency hospitals
2. Intersect the service area with 1km x 1km grids and municipalities including population data
3. Sum up the population for the individual age groups by sex and for the total population
3. Compare results on grids with results on municipality units
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

6. Advantages of using grids
GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014

7. GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014
Results: Bulgaria
GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014

8. Results: Czech Republic
GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014

9. GISCO - WORKING PARTY MEETING,
Results: Estonia
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

10. GISCO - WORKING PARTY MEETING,
Results: Finland
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

11. GISCO - WORKING PARTY MEETING,
Results: Norway
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

12. Access to emergency hospitals
GISCO - WORKING PARTY MEETING, 18th and 19th of March 2014

13. GISCO - WORKING PARTY MEETING,
About the results
This case study proves the strengths of grid statistics
The main differences in between the countries in this accessibility study lie in:
Geographical coverage of emergency hospitals and is partly explained by differences in defining Emergency hospitals
Population distribution
Size and the physical geography (e.g. hilliness, coastline, lakes) of the countries
Road network (incl. coverage and speed limits)
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014

14. GISCO - WORKING PARTY MEETING,
Further work
To assess the equity of geographical access to health care services (ECHI) this study needs to:
agree on how to define Emergency hospitals based on Emergency Medical Services (EMS) in all European countries
include traffic load as limiting factor for the accessibility
include emergency transports by helicopter, plane or and boat when generating Service Areas
add an additional service area with a lower driving time distance
Consequences of applying different confidentiality thresholds
However, this might give a better understanding of why the ECHI interviewees reply differently based on nationality
GISCO - WORKING PARTY MEETING,
18th and 19th of March 2014