Urban Environmental Determinants and Spatiotemporal Patterns of Emergency Medical Service Response to Traumatic Injuries

A Five-Year Population-Based Study

Bibliographic Data

ID15488980
AuthorsAkerke Chayakova (0000-0002-8398-3684, Astana Medical University), Oxana Tsigengagel (Astana Medical University, corresponding author)
Year2026
Volume23
Issue4
Pages434-434
Publication date2026-03-30
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph23040434
OpenAlexW7143355683
LanguageEN
References cited36

Background: Timely prehospital management is critical for survival after traumatic injury. In rapidly growing metropolises, emergency medical service (EMS) systems often struggle to provide equitable care amid urban sprawl and traffic congestion. This study investigated spatiotemporal inequalities in trauma-related EMS response in a rapidly expanding capital city (Astana, Kazakhstan) to inform healthcare optimization and urban health equity. Methods: We analyzed a five-year population-based dataset of 26,073 trauma-related EMS calls recorded between 2020 and 2024. Spatial patterns were examined using Kernel Density Estimation (KDE) and Getis–Ord Gi* hotspot analysis. Road-network modeling assessed accessibility at 3, 5, and 10 min thresholds using a GIS-based network analyst framework. Results: Males accounted for 60.1% of utilization and had higher clinical severity (hospitalization rate: 45.5% vs. 40.3%, p < 0.001). Demand peaked at 20:00, coinciding with peak traffic. The mean total response time was 21.63 min, and only 16.9% of calls met the 10 min benchmark. Significant accessibility gaps were found in the Baikonur district (61.4% delay rate). Conclusions: The findings demonstrate that while the EMS system provides broad geographic coverage, it suffers from systemic spatiotemporal bottlenecks. Targeted infrastructure expansion in underserved peripheral districts and the implementation of dynamic deployment models are necessary to enhance urban health equity and reduce preventable mortality in expanding metropolitan areas

Equity (law · Geographic information system · Health care · Inequality · Metropolitan area · Occupational safety and health · Poison control · Software deployment · Urban sprawl · Traffic and Road Safety · Trauma and Emergency Care Studies · Urban Transport and Accessibility · Emergency Medical Services

Tools

Open DOIOpen Access