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Potential Access to Emergency General Surgical Care in Ontario

Author

Listed:
  • Jordan Nantais

    (Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
    Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, MB R3A 1R9, Canada)

  • Kristian Larsen

    (CAREX Canada, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6T 1Z3, Canada
    Department of Geography and Planning, University of Toronto, Toronto, ON M5S 3G3, Canada
    Department of Geography and Environmental Studies, Ryerson University, Toronto, ON M5B 2K3, Canada)

  • Graham Skelhorne-Gross

    (Department of Surgery, Division of General Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada)

  • Andrew Beckett

    (Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
    Department of Surgery, Division of General Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada)

  • Brodie Nolan

    (Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
    Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada)

  • David Gomez

    (Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
    Department of Surgery, Division of General Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
    Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada)

Abstract

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.

Suggested Citation

  • Jordan Nantais & Kristian Larsen & Graham Skelhorne-Gross & Andrew Beckett & Brodie Nolan & David Gomez, 2022. "Potential Access to Emergency General Surgical Care in Ontario," IJERPH, MDPI, vol. 19(21), pages 1-8, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13730-:d:950314
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    References listed on IDEAS

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    1. Riccardo Di Domenicantonio & Giovanna Cappai & Paolo Sciattella & Valeria Belleudi & Mirko Di Martino & Nera Agabiti & Francesca Mataloni & Roberto Ricci & Carlo Alberto Perucci & Marina Davoli & Dani, 2016. "The Tradeoff between Travel Time from Home to Hospital and Door to Balloon Time in Determining Mortality among STEMI Patients Undergoing PCI," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-13, June.
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