Spatio-temporal epidemiology of emergency medical requests in a large urban area. A scan-statistic approach

Pre-hospital care is provided by emergency medical services (EMS) staff, the initial health care providers at the scene of disaster. This study aimed to describe the characteristics of EMS callers and space-time distribution of emergency requests in a large urban area. Descriptive thematic maps of EMS requests were created using an empirical Bayesian smoothing approach. Spatial, temporal and spatio-temporal clustering techniques were applied to EMS data based on Kulldorff scan statistics technique. Almost 225,000 calls were registered in the EMS dispatch centre during the study period. Approximately two-thirds of these calls were associated with an altered level of patient consciousness, and the median response time for rural and urban EMS dispatches was 12.2 and 10.1 minutes, respectively. Spatio-temporal clusters of EMS requests were mostly located in central parts of the city, particularly near the downtown area. However, high-response time clustered areas had a low overlap with these general, spatial clusters. This low convergence shows that some unknown factors, other than EMS requests, influence the high-response times. The findings of this study can help policymakers to better allocate EMS resources and implement tailored interventions to enhance EMS system in urban areas.

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Spatio-temporal variability of methane (CH4 ) concentrations and diffusive fluxes from a tropical coastal embayment surrounded by a large urban area (Guanabara Bay, Rio de Janeiro, Brazil)

Limnology and Oceanography ◽

10.1002/lno.10298 ◽

2016 ◽

Vol 61 (S1) ◽

pp. S238-S252 ◽

Cited By ~ 22

Author(s):

Luiz C. Cotovicz ◽

Bastiaan A. Knoppers ◽

Nilva Brandini ◽

Dominique Poirier ◽

Suzan J. Costa Santos ◽

...

Keyword(s):

Urban Area ◽

Temporal Variability ◽

Rio De Janeiro ◽

Guanabara Bay ◽

Large Urban Area ◽

Coastal Embayment ◽

Spatio Temporal ◽

Diffusive Fluxes

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Utilization of Emergency Medical Services in a Large Urban Area: Description of Call Types and Temporal Trends

Prehospital Emergency Care ◽

10.3109/10903127.2011.561403 ◽

2011 ◽

Vol 15 (3) ◽

pp. 371-380 ◽

Cited By ~ 27

Author(s):

Kevin G. Munjal ◽

Robert A. Silverman ◽

John Freese ◽

James D. Braun ◽

Bradley J. Kaufman ◽

...

Keyword(s):

Emergency Medical Services ◽

Urban Area ◽

Temporal Trends ◽

Medical Services ◽

Large Urban Area ◽

Emergency Medical

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178 Increasing Prevalence of Senior Citizen Frequent Users of Emergency Medical Services in Large, Urban Area

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2015.07.210 ◽

2015 ◽

Vol 66 (4) ◽

pp. S63 ◽

Cited By ~ 1

Author(s):

S. Sanko ◽

M. Eckstein

Keyword(s):

Emergency Medical Services ◽

Urban Area ◽

Senior Citizen ◽

Medical Services ◽

Large Urban Area ◽

Frequent Users ◽

Emergency Medical

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MO211FORMALIZATION AND DEVELOPMENT OF A NEPHROLOGY ELECTRONIC CONSULTATION (ECONSULT) IN COVID-19 PANDEMIC

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab092.0089 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Juan Carlos Herrero Berron ◽

Carolina Lentisco ◽

Aniana Oliet ◽

Andrea Suso ◽

Irene Onate Alonso ◽

...

Keyword(s):

Primary Care ◽

Response Time ◽

Primary Care Providers ◽

Care Providers ◽

Median Response ◽

Face To Face ◽

Problem Resolution ◽

Day Range ◽

Electronic Consultation

Abstract Background and Aims Due to COVID-19 pandemic we must continue attending in our hospital consultations and, at the same time, avoid transfers and visit that involve risks to our patients. For this reason, we implemented new forms of care. Mainly electronic consultation (eConsult) using institutional email as way of contact between Primary Care Providers (PCPs) and nephrologist, trying to decrease in-person visit. Objective To analyze the results of the creation in June 2020 of a Nephrology electronic consultation in our hospital. Method Retrospective observational study of eConsults made to our department, which serves a population of 200.000 people, with total of 9 primary care centers. The study period was June 10, 2020 to December 31, 2020. We have studied the number of eConsults, response time, type of consult made, problem resolution and subsequent follow up. Results Of 141 workdays, in 61 days (43%) there was eConsult, total 80 eConsults, mean 1.3 and median 1 daily (range 1 to 3). All primary care centers used this communication way, as well as 50 PCPs. Median response time for eConsult was 1 day (range 1-4). 55% patient was male, mean age 70.8 years (SD 13.9) (range 16-95 years). 64% it was his first assessment for Nephrology. The most frequent causes of eConsult: increase of creatinine (41.3%), uncontrolled blood pressure (12.5%), sodium and potassium disturbances (11.3%), treatment adjustment (11.3%) and changes in previous appointment (8.8%). After assessment eConsult, to 55% of patients was treatment adjustment, 22.5% were converted to an in-person visit, 11% they didn´t need any action but only 1 patient was referred to the emergency room. 44% patient is subsequent follow up by PCPs, 39% by nephrologist, 15% joint assessment PCP and nephrologist and 2% by other specialists. Only 2 patients (2.5%) made second eConsult. Conclusion The eConsult is an important help to PCPs to solve doubts quickly, avoid unnecessary the travels to hospital the patients, treatment adjustment above all in control of hypertension an ionic disturbance, and guide in handling of chronic kidney disease. The diffusion and empowerment of this type of consultation in a next future may decrease, partly, the usual saturation of face-to-face visit and optimize the patient population being seen by nephrologist.

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Spatio-temporal dynamics of schistosomiasis in Rwanda between 2001 and 2012: impact of the national Neglected Tropical Disease control programme

Geospatial health ◽

10.4081/gh.2017.514 ◽

2017 ◽

Vol 12 (1) ◽

Author(s):

Elias Nyandwi ◽

Tom Veldkamp ◽

Frank Badu Osei ◽

Sherif Amer

Keyword(s):

Temporal Dynamics ◽

Public Health Problem ◽

Incidence Rates ◽

Control Programme ◽

Scan Statistics ◽

Major Public Health Problem ◽

Implementation Phase ◽

Incidence Data ◽

Spatio Temporal ◽

The Impact

Schistosomiasis is recognised as a major public health problem in Rwanda. We aimed to identify the spatio-temporal dynamics of its distribution at a fine-scale spatial resolution and to explore the impact of control programme interventions. Incidence data of Schistosoma mansoni infection at 367 health facilities were obtained for the period 2001-2012. Disease cluster analyses were conducted using spatial scan statistics and geographic information systems. The impact of control interventions was assessed for three distinct sub-periods. Findings demonstrated persisting, emerging and re-emerging clusters of schistosomiasis infection across space and time. The control programme initially caused an abrupt increase in incidence rates during its implementation phase. However, this was followed by declining and disappearing clusters when the programme was fully in place. The findings presented should contribute to a better understanding of the dynamics of schistosomiasis distribution to be used when implementing future control activities, including prevention and elimination efforts.

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