A spatiotemporal analysis of emergency medical services use for palliative situations in Cape Town, South Africa
Background. Approximately 56.8 million people worldwide require palliative care annually, while only 14% receive such care. Within low- to middle-income countries (LMICs), this imbalance is prominent, as these countries contain up to 80% of patients requiring palliative care. To correct this im...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
South African Medical Association
2025-05-01
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| Series: | South African Medical Journal |
| Subjects: | |
| Online Access: | https://samajournals.co.za/index.php/samj/article/view/2506 |
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| Summary: | Background. Approximately 56.8 million people worldwide require palliative care annually, while only 14% receive such care. Within low- to middle-income countries (LMICs), this imbalance is prominent, as these countries contain up to 80% of patients requiring palliative care. To correct this imbalance, palliative care integration with other disciplines has been recommended. One developing area of integration in the South African (SA) LMIC context involves emergency medical services (EMS).
Objectives. To describe the geographical and temporal distribution of the EMS and palliative situation intersection in Cape Town, SA.
Methods. A descriptive, retrospective patient record review was employed at two hospitals in Cape Town. Records of patients who received palliative care at hospitals after EMS transport between 1 January 2020 and 31 December 2020 were included. EMS intersection with palliative situations according to the time of day, working hours, day of the week and month of the year were subjected to χ2 testing for temporal analysis. Geospatial data were investigated using cluster and proximity analyses.
Results. Overall, 494 instances of EMS palliative situation transport were identified. Most occurred in peri-urban areas (78%, n=385), during the daytime (52%, n=257), out of office hours (53%, n=261) and on weekdays (76%, n=375). Statistically significant variation in distribution was found according to time of day (p<0.001), with 38% (n=188) of cases occurring between 13h00 and 19h00, and month of year (p<0.001), with 54% (n=267) occurring from June to October. Proximity analysis revealed a mean driving time of 6.69 minutes and distance of 3.65 km to palliative care facilities.
Conclusion. EMS are frequently used for access to palliative care at any time of the day, week or year, particularly in peri-urban areas. EMS may further improve access through integration with palliative care. This efficient use of constrained resources should be pursued in SA, focusing on areas of increased demand.
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| ISSN: | 0256-9574 2078-5135 |