Disparities between Rural and Urban Areas of the Central Region of Saudi Arabia in the Utilization and Time-Centeredness of Emergency Medical Services

The purpose of this study was to explore differences in characteristics of missions dispatched by Emergency Medical Services (EMS) between rural and urban areas of Riyadh province in Saudi Arabia (SA). It also aimed at identifying weaknesses related to utilization and Response Time (RT). The study retrospectively evaluated 146,639 completed missions in 2018 by measuring the utilization rate in rural and urban areas. The study shows there are six times more ambulance crews available for rural areas compared to urban. There were 22.1 missions per 1000 urban inhabitants and 11.2 missions per 1000 in rural areas. The median RT for high urgent trauma cases was 20.2 min in rural compared to 15.2 min in urban areas (p < 0.001). In urban areas, the median RT for high urgent medical cases was 16.1 min, while it was 15.2 min for high urgent trauma cases. Around 62.3% of emergency cases in urban and 56.5% in rural areas were responded to within 20.00 min. Women utilized EMS less frequently. The RT was increased in urban areas compared to previous studies. The RT in the central region of SA has been identified as equal, or less than 20.00 min in 62.4% of all emergency cases. To further improve adherence to the 20′ target, reorganizing the lowest urgent cases in the rural areas seems necessary.

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Organisational factors affecting emergency medical services’ performance in rural and urban areas of Saudi Arabia

BMC Health Services Research ◽

10.1186/s12913-021-06565-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahmed Ramdan M Alanazy ◽

John Fraser ◽

Stuart Wark

Keyword(s):

Saudi Arabia ◽

Emergency Medical Services ◽

Rural Areas ◽

Urban Areas ◽

Medical Services ◽

Time Service ◽

Rural And Urban Areas ◽

Emergency Medical ◽

Rural And Urban ◽

Organisational Factors

Abstract Background There is a disparity in outcomes between rural and urban emergency medical services (EMS) around the world. However, there is a scarcity of research that directly asks EMS staff in both rural and urban areas how service delivery could be improved. The aim of the present study is to gain insights from frontline workers regarding organisational factors that may underpin discrepancies between rural and urban EMS performance. Subject and methods The study was undertaken in the Riyadh region of Saudi Arabia. Potential participants were currently employed by Saudi Red Crescent EMS as either a technician, paramedic or an EMS station manager, and had a minimum of five years experience with the EMS. Semi-structured interviews were undertaken between October 2019 and July 2020 with first respondents to a call for participants, and continued until data saturation was reached. All interviews were conducted in Arabic and transcribed verbatim. The Arabic transcript was shared with each participant, and they were asked to confirm their agreement with the transcription. The transcribed interviews were then translated into English; the English versions were shared with bi-lingual participants for validation, while independent certification of the translations were performed for data from participants not fluent in English. A thematic analysis methodological approach was used to examine the data. Results The final sample involved 20 participants (10 rural, 10 urban) from Saudi Red Crescent EMS. Data analyses identified key organisational factors that resulted in barriers and impediments for EMS staff. Differences and similarities were observed between rural and urban respondents, with identified issues including response and transportation time, service coordination, reason for call-out, as well as human and physical resourcing. Conclusion The findings identified key issues impacting on EMS performance across both rural and urban areas. In order to address these problems, three changes are recommended. These recommendations include a comprehensive review of rural EMS vehicles, with a particular focus on the age; incentives to improve the numbers of paramedics in rural areas and more localised specialist training opportunities for rurally-based personnel; and the implementation of national public education program focusing on the role of the EMS.

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Provision of Emergency Medical Services in Rural and Urban Saudi Arabia: An overview of personnel experiences

Asia Pacific Journal of Health Management ◽

10.24083/apjhm.v16i2.559 ◽

2021 ◽

Vol 16 (2) ◽

pp. 148-157

Author(s):

Ahmed Alanazy ◽

John Fraser ◽

Stuart Wark

Keyword(s):

Saudi Arabia ◽

Emergency Medical Services ◽

Urban Areas ◽

Public Awareness ◽

Organizational Factors ◽

Medical Services ◽

Rural And Urban Areas ◽

Awareness Campaigns ◽

Emergency Medical ◽

Rural And Urban

Objective: Pre-hospital emergency medical services (EMS) are a vital component of health management, however there are disparities in the provision of EMS between rural and urban locations. While rural people experience lower levels of pre-hospital care, there has been little examination of the reasons underpinning these differences through discussion with the providers of EMS, and particularly in countries other than the USA, UK and Australia. The purpose of this paper is to provide an overview of the lived experience of EMS personnel in Saudi Arabia regarding the key issues they face in their work practice. Design: This research focussed on frontline workers and middle-level station managers within the Saudi Arabian EMS system and adopted a hermeneutic phenomenology design to better understand the factors contributing to observed disparities between rural and urban areas in Riyadh region in Saudi Arabia. A semi-structured interview approach was used to collect data reflecting realistic experiences of EMS personnel in both urban and rural locations. Results: 20 interviews (10 each with rural and urban personnel) were done. Data analyses identified three primary thematic categories impacting EMS delivery: EMS Personnel Factors; Patient Factors; and, Organisational Factors. Underpinning each category were sub-themes, including Working Conditions, Stress, Education and training, and Resources, amongst others. Conclusions: The quality and efficiency of EMS services, in both rural and urban areas, was affected by a number of over-arching organizational factors. Implementing major policy shifts, such as recruitment of female EMS professionals, will be critical in addressing these challenges, but is acknowledged that this will take time. Quicker changes, such as improving the advanced training options for rural EMS staff, may help to remediate some of the issues. Public awareness campaigns may also be effective in addressing the identified misconceptions about the role of EMS in Saudi Arabia.

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Organisational factors affecting Emergency Medical Services’ performance in rural and urban areas of Saudi Arabia

10.21203/rs.3.rs-279486/v1 ◽

2021 ◽

Author(s):

Ahmed Ramdan M Alanazy ◽

John Fraser ◽

Stuart Wark

Keyword(s):

Developing Countries ◽

Saudi Arabia ◽

Emergency Medical Services ◽

Urban Areas ◽

Medical Services ◽

Time Service ◽

Rural And Urban Areas ◽

Emergency Medical ◽

Rural And Urban ◽

Organisational Factors

Abstract Background:There is a disparity in outcomes between rural and urban emergency medical services (EMS) in both developed and developing countries. However, there is a scarcity of research that directly asks EMS staff in both rural and urban areas of developing countries how service delivery could be improved. The aim of the present study is to gain insights from frontline workers regarding organisational factors that may underpin discrepancies between rural and urban EMS performance.Subject and Methods:The study was undertaken in the Riyadh region of Saudi Arabia, with 20 participants (10 rural, 10 urban) drawn from Saudi Red Crescent EMS. Semi-structured interviews were undertaken between October 2019 and July 2020. All interviews were conducted in Arabic, transcribed verbatim and translated into English. Results:Data analyses identified key organisational factors that resulted in barriers and impediments for EMS staff. Differences and similarities were observed between rural and urban respondents, with identified issues including response and transportation time, service coordination, reason for call-out, as well as human and physical resourcing.Conclusion:The findings identified key issues impacting on EMS performance across both rural and urban areas. In order to address these problems, changes are recommended. These recommendations include a comprehensive review of rural EMS vehicles, with a particular focus on the age; incentives to improve the numbers of paramedics in rural areas and more localised specialist training opportunities for rurally-based personnel; and the implementation of national public education program focusing on the role of the EMS.

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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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Trend Analyses of Emergency Medical Services for Motor Vehicle Crashes: Michigan Case Study

Transportation Research Record Journal of the Transportation Research Board ◽

10.3141/2635-07 ◽

2017 ◽

Vol 2635 (1) ◽

pp. 55-61

Author(s):

Anil Kumar ◽

Osama Abudayyeh ◽

Tycho Fredericks ◽

Megan Kuk ◽

Michelle Valente ◽

...

Keyword(s):

Emergency Medical Services ◽

Urban Areas ◽

Motor Vehicle ◽

Medical Services ◽

Vehicle Crashes ◽

Rural And Urban Areas ◽

Emergency Medical ◽

Vehicle Collision ◽

Rural And Urban ◽

Timely Response

The timely response of emergency medical services (EMS) personnel at a crash site may help prevent loss of life and thereby impact the quality of life for an individual at risk. Thus, availability of and access to quantitative data on EMS activities is critical. This study was conducted to review the data collected by the Michigan Department of Community Health, Emergency Medical Services Section, from a five-year period starting in 2010. The intent was to identify current EMS response, treatment, and transport trends. Among the results noted in this paper, it was identified that on average, the total times involved from the dispatch call to the drop-off of a patient from a motor vehicle collision (MVC) in Michigan were approximately 56 and 43 min for rural and urban areas, respectively. The results from this study could be utilized to guide and direct future EMS initiatives relating to MVCs. The analysis might also be beneficial in predicting the types of injuries that occur in specific types of vehicle crashes. Several challenges and recommendations are provided in the paper.

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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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Suspected Miscarriage in the Experience of Emergency Medical Services Teams—Preliminary Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312305 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12305

Author(s):

Ewa Rzońca ◽

Agnieszka Bień ◽

Grażyna Bączek ◽

Patryk Rzońca ◽

Michał Filip ◽

...

Keyword(s):

Emergency Medical Services ◽

Health Care Professionals ◽

Rural Areas ◽

Urban Areas ◽

Vaginal Bleeding ◽

Medical Services ◽

Medical Procedure ◽

Emergency Medical ◽

Gestational Week ◽

Team Interventions

Vaginal bleeding and abdominal pain are symptoms indicative of a threat to pregnancy that prompt women to seek assistance from health care professionals. The purpose of the study was to present the characteristics of Emergency Medical Services (EMS) team interventions in cases of suspected miscarriage. The study involved a retrospective analysis of EMS team interventions in cases of suspected miscarriage carried out between January 2018 and December 2019 in Poland. Data obtained from Poland’s National Monitoring Center of Emergency Medical Services included emergency medical procedure records and EMS team dispatch records in electronic format. The mean patient age was 30.53 years. Most were primiparous (48.90%) and up to the 13th gestational week (76.65%). The most commonly reported symptom was vaginal bleeding (80.71%). EMS teams were most commonly dispatched in the winter (27.03%), between 7 A.M. and 6:59 P.M. (51.87%), in urban areas (69.23%), with urgency code 2 (55.60%), and in most cases, they transferred the patient to a hospital (97.53%). The present study addresses very important issues concerning the characteristics of Polish suspected miscarriage cases handled by different EMS team types, in different locations (urban vs. rural areas), and concerning patients in a different obstetric situation (gestational week, gravidity, parity). Our findings suggest a need for further studies in this field and for gestational health promotion activities to be implemented, specifically including actions to reduce the risk of vaginal bleeding during pregnancy.

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A comparison of pre-hospital emergency medical services’ response and duration times in urban versus rural areas of Saudi Arabia

Australasian Journal of Paramedicine ◽

10.33151/ajp.17.805 ◽

2020 ◽

Vol 17 ◽

Author(s):

Ahmed Ramdan M Alanazy ◽

Stuart Wark ◽

John Fraser ◽

Amanda Nagle

Keyword(s):

Saudi Arabia ◽

Response Time ◽

Emergency Medical Services ◽

Outcome Measures ◽

Rural Areas ◽

Response Times ◽

Medical Services ◽

Industrial Accidents ◽

Emergency Medical ◽

Urban Versus

Background Response impacts on treatment outcomes, particularly for time-sensitive illnesses, including trauma. This study compares key outcome measures for emergency medical services (EMS) operating in urban versus rural areas in the Riyadh region of Saudi Arabia. Methods A cross-sectional study of EMS users was conducted using a random sampling method. Primary outcome measures were response time, on-scene time, transport time interval and survival rates. Secondary outcomes were the length of stay in the intensive care unit and hospital. Data were compared between the urban and rural groups using the t-test and chi-square test. Results Eight-hundred patients (n=400 urban, n=400 rural) were included in the final analysis. Cases in rural areas had significantly higher response times and duration times (median response 15 vs. 22 minutes, median duration 43 vs. 62 minutes). Response times were significantly longer for rural areas for MVC, industrial accidents, medical incidents and trauma, but there was no significant difference in duration time for industrial accidents. While urban areas had significantly shorter response times for all incident types, there was no difference with rural areas in duration time for chest injury, gastrointestinal, neurological or respiratory problems. Conclusion The findings indicate that response time and duration differs between urban and rural locations in a number of key areas. The factors underlying these differences need to be the subject of specific follow-up research in order to make recommendations as to the best way to improve EMS in Saudi Arabia and to close the gap in rural and urban service delivery.

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Thinking of Village Construction in Central Region under the Context of Labor Migration

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.507.666 ◽

2014 ◽

Vol 507 ◽

pp. 666-674

Author(s):

Pan Yi ◽

Li Xin ◽

Sheng Yu Guo

Keyword(s):

Central Region ◽

Rural Areas ◽

Labor Migration ◽

Urban Areas ◽

Negative Impact ◽

Floating Population ◽

Rapid Urbanization ◽

Rural And Urban Areas ◽

Positive Effects ◽

Rural And Urban

China’s 30 years’ rapid urbanization process is not a usual one but a particular process promoted in the dual social-economic structure like household registration policy and land system, According to the sixth census, China's floating population has reached 261 million, that is, among every three Chinese city's residents, there is one person belonging to the “Migrant-urbanization” group made up of migrant peasant workers. Large number of rural labor migration, on the one hand, it causes false components in the process of urbanization, on the other hand, it brings a lot of problems to village construction of the central region which is considered as population exporter. It also somehow gradually formed the result of the "amphibious" population who was not engaged in agricultural production, localization tendency of rural industries, sidelined agriculture, and the disordered development of towns and villages. This paper is based on the background that regional labor movement from backward areas to developed coastal areas.Furthermore, this paper analyzes both the positive effects and the negative impact of labor migration which brought about to the construction of the central region village in China. Finally, this paper proposed three strategies about construction of the central region village in China with the aim to contribute to the much better sustainable development of rural villages and improve the co-development of both the rural and urban areas, first, how to arrange the surplus rural laborers; how to make rural land use more economically and intensively; and how to balance the development of urban and rural areas.

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Analysis of Fatal Traffic Crash-Reporting and Reporting-Arrival Time Intervals of Emergency Medical Services

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198118772724 ◽

2018 ◽

Vol 2672 (32) ◽

pp. 61-71 ◽

Cited By ~ 2

Author(s):

Jaeyoung Lee ◽

Mohamed Abdel-Aty ◽

Qing Cai ◽

Ling Wang

Keyword(s):

Emergency Medical Services ◽

Rural Areas ◽

Urban Areas ◽

Medical Services ◽

Economic Factors ◽

Functional Classification ◽

Arrival Times ◽

Emergency Medical ◽

Time Required ◽

Socio Economic Factors

Emergency Medical Services (EMS) play a vital role in the postcrash effort to reduce fatalities by providing first aid and transportation to medical facilities. This study aims to analyze the time required for crash reporting and EMS arrival in fatal traffic crashes and to identify relevant crash, roadway, environmental and zonal socio-economic factors. The time required for EMS reporting and arrivals were calculated by location type (urban or rural) and roadway functional classification using Florida data. Subsequently, a variety of duration models were estimated to reveal the contributing factors for crash-reporting and reporting-arrival intervals. Although about 90% of fatal crashes are reported to EMS within ten minutes in both urban and rural settings, EMS average reporting time in rural areas (4.5 min) is greater than that in urban areas (3 min). Moreover, freeways require longer time for EMS arrival (8.3 min) compared with conventional roadways (6.8 min). It was shown that the log-logistic and gamma models performed the best for crash-reporting and reporting-arrival intervals, respectively. The modeling results revealed that both EMS reporting and arrival times are related to the crash, roadway, environmental, and socio-economic factors. The key findings indicate that EMS reporting and arrival times differ significantly according to the urban or rural designation and road functional classification, and that they have statistically significant relationship with various factors. It is expected that the findings from this study can be used to develop effective and practical strategic plans to minimize EMS reporting and arrival times and, therefore, decrease the likelihood of fatalities.

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