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{
    "pk": 11769,
    "title": "Use of Fine-Scale Geospatial Units and Population Data to Evaluate Access to Emergency Care",
    "subtitle": null,
    "abstract": "Introduction: Time to facility is a crucial element in emergency medicine (EM). Fine-scale geospatial units such as census block groups (CBG) and publicly available population datasets offer a low-cost and accurate approach to modeling geographic access to and utilization of emergency departments (ED). These methods are relevant to the emergency physician in evaluating patient utilization patterns, emergency medical services protocols, and opportunities for improved patient outcomes and cost utilization. We describe the practical application of geographic information system (GIS) and fine-scale analysis for EM using Ohio ED access as a case study.\nMethods: Ohio ED locations (n=198), CBGs (n=9,238) and 2015 United States Census five-year American Community Survey (ACS) socioeconomic data were collected July—August 2016. We estimated drive time and distance between population-weighted CBGs and nearest ED using ArcGIS and 2010 CBG shapefiles. We examined drive times vs. ACS characteristics using multinomial regression and mapping.\nResults: We categorized CBGs by centroid-ED travel time in minutes: <10 (73.4%; n=6,774), 10-30 (25.1%; n=2,315), and >30 (1.5%; n=141). CBGs with increased median age, Hispanic and non-Hispanic Black population, and college graduation rates had significantly decreased travel time. CBGs with increased low-income populations (adjusted odds ratio [AOR] [1.03], 95% confidence interval [CI] [1.01-1.04]) and vacant housing (AOR [1.06], 95% CI [1.05-1.08]) had increased odds of >30 minute travel time.\nConclusion: Use of fine-scale geographic analysis and population data can be used to evaluate geographic accessibility and utilization of EDs. Methods described offer guidance to approaching questions of geographic accessibility and have numerous ED and pre-hospital applications.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Geography"
        },
        {
            "word": "emergency department"
        },
        {
            "word": "access to care"
        },
        {
            "word": "Population Health"
        }
    ],
    "section": "Public Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/7gg5n438",
    "frozenauthors": [
        {
            "first_name": "Katherine",
            "middle_name": "M.",
            "last_name": "Joyce",
            "name_suffix": "",
            "institution": "Northeast Ohio Medical University, School of Medicine, Rootstown, Ohio",
            "department": "None"
        },
        {
            "first_name": "Ryan",
            "middle_name": "C.",
            "last_name": "Burke",
            "name_suffix": "",
            "institution": "Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio.\nKent State University, Department of Public Health, Kent, Ohio",
            "department": "None"
        },
        {
            "first_name": "Thomas",
            "middle_name": "J.",
            "last_name": "Veldman",
            "name_suffix": "",
            "institution": "Kent State University, Department of Geography, Kent, Ohio",
            "department": "None"
        },
        {
            "first_name": "Michelle",
            "middle_name": "M.",
            "last_name": "Beeson",
            "name_suffix": "",
            "institution": "Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio",
            "department": "None"
        },
        {
            "first_name": "Erin",
            "middle_name": "L",
            "last_name": "Simon",
            "name_suffix": "",
            "institution": "Northeast Ohio Medical University, School of Medicine, Rootstown, Ohio, \nCleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio",
            "department": "None"
        }
    ],
    "date_submitted": "2018-05-10T00:34:30Z",
    "date_accepted": "2018-05-10T00:34:30Z",
    "date_published": "2018-10-18T19:22:59Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/11769/galley/6313/download/"
        }
    ]
}