Relationship between Neighborhood Characteristics and Demand for Emergency Health Service Vehicles: A Poisson Hurdle Regression Modeling Approach

The main objective of this study is to explore the spatial and temporal variability of demand for emergency health service vehicles, measured at the 1 km-by-1 km grid level in Halifax, Nova Scotia, Canada. This study utilizes and compares a Poisson regression and Poisson hurdle regression model that examine the effects of neighborhood characteristics on emergency health service vehicle demand. It also develops a time-segmented model to investigate the temporal variability of the effects of factors considered in relation to demand. It analyzes the Nova Scotia emergency health service administrative database for the period from January 2012 to December 2012. A comprehensive set of socio-demographic attributes, land use characteristics, and measures of accessibility to services are used to achieve the objectives of this research. Results found that demand for emergency health service vehicles was higher in areas where there was higher population density, more heterogeneous land uses, and a larger proportion of the population aged 40 years and above. The time-segmented model shows demand was highest during morning peak periods for residential areas, afternoon peak for commercial areas, and morning peak and midday for members of the population aged over 75 years. An assessment of the time-segmented model suggests that the generic model is sufficient for predicting how neighborhood characteristics relate to the demand for emergency health service vehicles. The findings of this study will be beneficial for urban planners and health professionals in designing healthy cities and targeting health promotions to reduce the need for emergency services.