Do poorer neighborhoods experience longer ambulance times?

Bottom Line: Patients from the poorest neighborhoods who had cardiac arrest had longer total ambulance times than those from the wealthiest neighborhoods.

Why The Research Is Interesting: Emergency medical services (EMS) provide critical care before patients reach the hospital and differences in ambulance times may contribute to disparities in patient outcomes.

What and When: National data from 46 states on 63,600 patients who had cardiac arrest and didn’t die on scene and were transported to a hospital

What (Study Measures and Outcomes): Four time measures were examined (response time, on-scene time, transport time and total EMS time) and compared with EMS response time benchmarks for responding to cardiac arrest calls.

How (Study Design): This was an observational study. Researchers weren’t intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

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Authors: Renee Y. Hsia, M.D., M.Sc., University of California, San Francisco, and coauthors

Study Limitations: The registry analyzed for this study wasn’t of individual patients so multiple reports associated with the same patient exist; other explanations beyond the variables assessed in this study may have contributed to time disparities; and the findings may not be generalized to other types of time-sensitive EMS calls.

Related Material: The invited commentary, “Income and Ambulance Response Time Inequality–No Simple Explanation, No Simple Fix,” by Andrew I. Friedson, Ph.D., University of Colorado Denver, also is available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamanetworkopen.2018.4945)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

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