Key result
Geographic access to any emergency general surgery care within a 30-minute drive was available to 96% of the Ontario population, while access to all factors including 24/7 ORs was 93%.
Why the study?
Limited access to timely emergency general surgery care is a probable driver of increased mortality and morbidity, but potential access in Ontario had not been estimated.
Observational
The vast majority of the Ontario population has geographic access to emergency general surgery within 30 minutes, though access to 24/7 operating rooms is slightly more limited and clustered around metropolitan centers.
Broad access to emergency general surgery in Ontario informs health system mapping; leaves open links to outcomes and rural disparities.
Limited access to timely emergency general surgery (EGS) care is a probable driver of increased mortality and morbidity. Our objective was to estimate the portion of the Ontario population with potential access to 24/7 EGS care. Geographic information system-based network-analysis was used to model 15-, 30-, 45-, 60-, and 90-min land transport catchment areas for hospitals providing EGS care, 24/7 emergency department (ED) access, and/or 24/7 operating room (OR) access. The capabilities of hospitals to provide each service were derived from a prior survey. Population counts were based on 2016 census blocks, and the 2019 road network for Ontario was used to determine speed limits and driving restrictions. Ninety-six percent of the Ontario population (n = 12,933,892) lived within 30-min’s driving time to a hospital that provides any EGS care. The availability of 24/7 EDs was somewhat more limited, with 95% (n = 12,821,747) having potential access at 30-min. Potential access to all factors, including 24/7 ORs, was only possible for 93% (n = 12,471,908) of people at 30-min. Populations with potential access were tightly clustered around metropolitan centers. Supplementation of 24/7 OR capabilities, particularly in centers with existing 24/7 ED infrastructure, is most likely to improve access without the need for new hospitals.
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Nantais et al. (2022) conducted an observational in Emergency general surgery care access. Geographic access to 24/7 emergency general surgery care was evaluated on Potential access to 24/7 EGS care, 24/7 ED access, and 24/7 OR access within 30 minutes driving time. Geographic access to any emergency general surgery care within a 30-minute drive was available to 96% of the Ontario population, while access to all factors including 24/7 ORs was 93%.
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