Fatal motor vehicle crashes in Texas: needs for and access to emergency medical services

Abstract

Access to emergency medical services (EMS) was examined for fatal motor vehicle crashes (MVCs) in Texas. Actual needs for EMS were assessed using MVC fatality distribution; revealed EMS accessibility was evaluated using EMS utilization records. Total prehospital time records the time between a MVC occurrence and a victim’s arrival at hospital; it includes activation time, ambulance response time and hospital transport time. The revealed accessibility was compared to potential accessibility, which is based on assumed transportation time to trauma designated hospitals. It was found that although fatal MVCs were more concentrated in urban areas, the fatality rate was higher in rural Texas. The total prehospital time and the component time segments were longer in rural areas, confirming poor EMS access for rural Texas. Significant difference exists for EMS accessibility across the eight state-level health service regions. The study also points to a possible threshold distance or transport time, beyond which the actual access to EMS is poorer than would be expected.