Medical Services for Rural Areas: The Tennessee Medical Foundation. Willman A. Massie

ObjectivesThis study wants to assess the cost-effectiveness of unmanned aerial vehicles (UAV) equipped with automated external defibrillators (AED) in out-of-hospital cardiac arrests (OHCA). Especially in rural areas with longer response times of emergency medical services (EMS) early lay defibrillation could lead to a significant higher survival in OHCA.Participants3296 emergency medical stations in Germany.SettingRural areas in Germany.Primary and secondary outcome measuresThree UAV networks providing 80%, 90% or 100% coverage for rural areas lacking timely access to EMS (ie, time-to-defibrillation: >10 min) were developed using a location allocation analysis. For each UAV network, primary outcome was the cost-effectiveness using the incremental cost-effectiveness ratio (ICER) calculated by the ratio of financial costs to additional life years gained compared with current EMS.ResultsCurrent EMS with 3926 emergency stations was able to gain 1224 life years on annual average in the study area. The UAV network providing 100% coverage consisted of 1933 UAV with average annual costs of €43.5 million and 1845 additional life years gained on annual average (ICER: €23 568). The UAV network providing 90% coverage consisted of 1074 UAV with average annual costs of €24.2 million and 1661 additional life years gained on annual average (ICER: €14 548). The UAV network providing 80% coverage consisted of 798 UAV with average annual costs of €18.0 million and 1477 additional life years gained on annual average (ICER: €12 158).ConclusionThese results reveal the relevant life-saving potential of all modelled UAV networks. Furthermore, all analysed UAV networks could be deemed cost-effective. However, real-life applications are needed to validate the findings.

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Influence of community satisfaction with individual happiness: comparative study in semi-urban and rural areas of Tikapur, Nepal

Global Health Promotion ◽

10.1177/1757975916672169 ◽

2017 ◽

Vol 25 (3) ◽

pp. 22-32 ◽

Cited By ~ 2

Author(s):

Myung-Bae Park ◽

Chun-Bae Kim ◽

Chhabi Ranabhat ◽

Chang-Soo Kim ◽

Sei-Jin Chang ◽

...

Keyword(s):

Rural Areas ◽

Physical Environment ◽

Urban Areas ◽

Positive Relationship ◽

National Level ◽

Medical Services ◽

Community Satisfaction ◽

Critical Factors ◽

Urban And Rural Areas

Happiness is a subjective indicator of overall living conditions and quality of life. Recently, community- and national-level investigations connecting happiness and community satisfaction were conducted. This study investigated the effects of community satisfaction on happiness in Nepal. A factor analysis was employed to examine 24 items that are used to measure community satisfaction, and a multiple regression analysis was conducted to investigate the effects of these factors on happiness. In semi-urban areas, sanitation showed a positive relationship with happiness. In rural areas, edu-medical services were negatively related to happiness, while agriculture was positively related. Gender and perceived health were closely associated with happiness in rural areas. Both happiness and satisfaction are subjective concepts, and are perceived differently depending on the socio-physical environment and personal needs. Sanitation, agriculture (food) and edu-medical services were critical factors that affected happiness; however, the results of this study cannot be generalized to high-income countries.

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Asthma Deaths in Scotland 1965–1980

Scottish Medical Journal ◽

10.1177/003693308402900203 ◽

1984 ◽

Vol 29 (2) ◽

pp. 84-89 ◽

Cited By ~ 4

Author(s):

J. M. G. Wilson

Keyword(s):

Young People ◽

Hospital Admission ◽

Rural Health ◽

Rural Areas ◽

Medical Services ◽

England And Wales ◽

Admission Rates ◽

Level Of Significance ◽

Asthma Mortality

From 1965 the fall in asthma mortality in Scotland has parallelled that documented for England and Wales. The high proportion of deaths in young people, and deaths at home, is similar to findings elsewhere. Mortality is higher in the more rural health areas, which are characterised by poorer access to general medical services, fewer medical consultants to the population, and lower hospital admission rates for asthma. There is a slightly higher proportion of home deaths in these rural areas, though on the available data not reaching the level of significance. It is suggested that this difference in mortality between the more urban and the more rural areas provides a basis for a case study in detail.

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Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽

10.1542/peds.88.4.681 ◽

1991 ◽

Vol 88 (4) ◽

pp. 681-690 ◽

Cited By ~ 1

Author(s):

James S. Seidel ◽

Deborah Parkman Henderson ◽

Patrick Ward ◽

Barbara Wray Wayland ◽

Beverly Ness

Keyword(s):

Emergency Medical Services ◽

Rural Areas ◽

Urban Areas ◽

Pediatric Patients ◽

Life Support ◽

Prehospital Care ◽

Advanced Life Support ◽

Medical Services ◽

Care Providers ◽

Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P < .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

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Developing Security Solutions for Telemedicine Applications

Advances in Healthcare Information Systems and Administration - Smart Medical Data Sensing and IoT Systems Design in Healthcare ◽

10.4018/978-1-7998-0261-7.ch004 ◽

2020 ◽

pp. 76-96

Author(s):

Pavithra V. ◽

Jeyamala Chandrasekaran

Keyword(s):

Information Technology ◽

Image Encryption ◽

Rural Areas ◽

Medical Records ◽

Medical Image ◽

Slight Modification ◽

Medical Services ◽

Medical Applications ◽

Security Issues

Telemedicine is defined as the means of providing healthcare for people from a distance by the use of telecommunication and information technology. This technology is mainly useful in overcoming the obstacles of distance and provide enhancement in the access of medical services that would not be easily available in different rural areas. Telemedicine security includes issues such as confidentiality, integrity, and authentication that are also present in other systems involving information and data. Maintaining integrity of data stored and used is a huge problem for medical applications because it contains more sensitive medical records of patients which can cause severe ill effects on slight modification. In order to resolve the confidentiality and integrity issues of telemedicine applications, medical image encryption and watermarking comes into play. The security issues in telemedicine applications is to be given higher importance and thus choosing a reliable and effective approach or framework is more essential.

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Inequality and Influencing Factors of Spatial Accessibility of Medical Facilities in Rural Areas of China: A Case Study of Henan Province

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101833 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1833 ◽

Cited By ~ 4

Author(s):

Shirui Liu ◽

Yaochen Qin ◽

Yanan Xu

Keyword(s):

Influencing Factors ◽

Rural Areas ◽

Henan Province ◽

Spatial Accessibility ◽

Medical Services ◽

Basic Unit ◽

Mountainous Areas ◽

Geographically Weighted Regression Model ◽

Medical Facilities ◽

Spatial Differences

The equalization of medical services has received increasing attention, and improving the accessibility of medical facilities in rural areas is key for the realization of fairness with regard to medical services. This study studies the rural areas of Henan Province, China, and uses unincorporated villages as the basic unit. The spatial pattern of accessibility in rural areas was comprehensively analyzed via geographic information system spatial analysis and coefficient of variation. The spatial heterogeneity of relevant influencing factors was assessed by using the geographically weighted regression model. The results show that: (1) The distance cost of medical treatment in rural areas is normally distributed, and most areas are within a range of 2–6 km. (2) The accessibility in rural areas has clear spatial differences, is significantly affected by terrain, and shows characteristics of significant spatial agglomeration. The eastern and central regions have good spatial accessibility, while the western regions have poor spatial accessibility. Furthermore, regions with poor accessibility are mainly located in mountainous areas. (3) The spatial equilibrium of accessibility follows a pattern of gradual deterioration from east to west. The better accessibility-unbalanced type is mostly located in the center of Henan Province, while the poor accessibility-unbalanced type is concentrated in mountainous areas. (4) The area, elevation, residential density, and per capita industrial output are positively correlated with spatial accessibility, while road network density and population density are negatively correlated.

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Standard Precautions Among Emergency Medical Services in Urban and Rural Areas

Workplace Health & Safety ◽

10.1177/2165079919864118 ◽

2019 ◽

Vol 68 (2) ◽

pp. 73-80

Author(s):

Riyadh A. Alhazmi ◽

R. David Parker ◽

Sijin Wen

Keyword(s):

West Virginia ◽

Emergency Medical Services ◽

Rural Areas ◽

Urban Areas ◽

Medical Services ◽

Cross Sectional Survey ◽

Standard Precautions ◽

Cross Sectional ◽

Emergency Medical ◽

Rural And Urban

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers ( p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.

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Correlation of age and rurality with low-urgency use of emergency medical services (LUEMS): A geographic analysis

CJEM ◽

10.1017/cem.2017.364 ◽

2017 ◽

Vol 20 (6) ◽

pp. 874-881 ◽

Cited By ~ 1

Author(s):

Mikiko Terashima ◽

Alix J.E. Carter

Keyword(s):

Emergency Medical Services ◽

Public Transportation ◽

Rural Areas ◽

Tertiary Care ◽

Incidence Rates ◽

Medical Services ◽

Older Population ◽

Age Cohorts ◽

Geographic Analysis ◽

Emergency Medical

ABSTRACTObjectivesStudies suggest that addressing the needs of the older population in rural areas may substantially reduce their low-urgency use of emergency medical services (LUEMS). It may ultimately also help improve the efficiency in our health system. There is, however, a dearth of evidence substantiating geographic patterns in LUEMS by different age cohorts. This exploratory study was aimed to clarify the understanding of emergency medical services (EMS) use in Nova Scotia through a geographic analysis.MethodsRecords with Canadian Triage and Acuity Scale of 4 and 5 were considered as LUEMS. We assessed the distribution of LUEMS incidence rates (proportion of LUEMS out of all EMS uses) by age and rurality, using descriptive statistics and Geographic Information Systems mapping.ResultsNearly half of all EMS transports were individuals of 65+ years of age; 35% of those were LUEMS. The rates increased along with the level of rurality, and the older cohort had the highest incidence rates in non-metro communities. High rates were seen primarily in some rural communities farthest away from the capital/tertiary care centre.ConclusionHigh LUEMS incidence rates are rural phenomena but not specific to the older population. However, the absolute number of LUEMS by the older cohort is significant, and elder-specific interventions in rural regions could still lead to effective cost savings. Further investigation of other factors, such as distance to the emergency department, availability of public transportation, and socioeconomic conditions of EMS users, is needed.

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