Emergency Medical Services and Congestion : A Research Proposal

Synopsis Traffic congestion, upon first consideration, would appear to be a problem primarily of interest to those in the fields of engineering and transportation. While it is true these disciplines are principally responsible for characterizing and mitigating traffic congestion, in the " real world " its impact extends well beyond these fields. For example, traffic congestion has important environmental and worker productivity implications. Similarly, congestion-related pollution has come to be associated with certain chronic medical conditions. Moreover, of no small consequence is the reality that traffic congestion may have an impact on acute health problems resulting from delays in the provision of emergency medical services (EMS). For example, ambulances are not always able to avoid traffic congestion chokepoints. It follows that when there are even short delays in the delivery of care to a patient or delays in transporting a patient to definitive care, such delays can have adverse implications on outcomes. Thus, when viewed from a public health perspective the relationship between congestion and EMS reveals several important opportunities for multidisciplinary , translational research. The first of these opportunities focuses on the issue of primary prevention; that is, opportunities to prevent congestion-related EMS delays and thereby prevent adverse patient outcomes associated with such delays. Research has suggested that suburban areas have longer average EMS response times than urban areas. However, the specific relationship between urban sprawl and EMS response times remains unclear. With the rapid growth of suburbs, shifts towards a more elderly population, and the ongoing need for improved emergency preparedness, there is an urgent need for systematic evaluation of sprawl's impact on EMS delivery in the United States to identify opportunities for intervention. Towards this end, one component of the proposed study will quantify the association between urban sprawl and EMS response time in the United States using national EMS data linked to a widely used county-level sprawl index. This information may be useful to policy-makers considering land use alternatives in rapidly growing areas of the country. In addition to primary prevention, the issue of congestion and EMS can also be viewed from a secondary prevention perspective; that is, identifying early opportunities for interventions to minimize congestion from impacting patient outcomes. In contrast to primary prevention, which in the present case would be focused on preventing congestion-related delays, secondary prevention assumes such delays will occur yet attempts to minimize their impact. To accomplish this task, so as …