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ORIGINAL RESEARCH article

Front. Disaster Emerg. Med.
Sec. Emergency Health Services
Volume 2 - 2024 | doi: 10.3389/femer.2024.1402957
This article is part of the Research Topic Patient Safety and Patient-Centred Care in Emergency Medical Services and Adjoining Care Settings View all 7 articles

Socio-economic factors affecting spatial inequalities in pregnancyrelated ambulance attendances in Greater London

Provisionally accepted
Sam Murphy Sam Murphy 1*Chen Zhong Chen Zhong 1*Fulvio Lopane Fulvio Lopane 1Luke Rogerson Luke Rogerson 2Yi Gong Yi Gong 3
  • 1 Centre for Advanced Spatial Analysis, Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
  • 2 London Ambulance Service NHS Trust, London, United Kingdom
  • 3 Department of Arts and Sciences, Faculty of Arts & Humanities, University College London, London, England, United Kingdom

The final, formatted version of the article will be published soon.

    Exploring inequalities in ambulance and pre-hospital demand is important to improve service equity and reduce wider health inequalities. Maternity incidents amongst ambulance demand are a key area of focus because of the specialised care that is needed for patients, as well as the impact of wider determinants of health on pregnancy outcomes. Since there are spatial inequalities amongst pregnant patients who call for an ambulance, the aim of this study is to assess the underlying factors associated with pregnancy related ambulance complaints, to determine why maternity patients utilise the ambulance service. Local indicators of spatial autocorrelation were used to identify clusters of ambulance maternity demand within Greater London (UK). A negative binomial regression model was used to explore associations between socioeconomic, environmental, accessibility and demographic variables. Our results reveal that neighbourhoods with low adult skills (i.e. qualifications/English language abilities) have a higher rate of demand. Moreover, our results imply that the demand for ambulance services may not be directly tied to health outcomes; rather, it might be more closely associated with patients' reasons for calling an ambulance, irrespective of the actual necessity. The benefits of identifying factors that drive demand in ambulance services are not just linked to improving equity, but also to reducing demand, ultimately relieving pressure on services if alternative options are identified or underlying causes addressed. Doing so can improve health inequalities by firstly, improving ambulance care equity by directly supporting a better allocation of resources within ambulance systems to target patterns in demand.

    Keywords: Ambulance, Inequality, Maternity, Pregnancy, Pre-hospital, demand, Equity, Efficiency

    Received: 18 Mar 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Murphy, Zhong, Lopane, Rogerson and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sam Murphy, Centre for Advanced Spatial Analysis, Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
    Chen Zhong, Centre for Advanced Spatial Analysis, Bartlett Faculty of the Built Environment, University College London, London, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.