Time, island and ambulance type characteristics of patient transfers from two Turkish islands

Purpose The purpose of this paper is to evaluate the time, place and ambulance types specified on the ambulance patient registry forms for cases transferred through 112 EMS in the Bozcaada and Gökçeada island districts of the province of Çanakkale. Design/methodology/approach The universe of the descriptive – cross-sectional epidemiological study was composed of the ambulance patient registration forms of the cases which were transferred from Bozcaada and Gökçeada islands between January 1, 2009 and December 31, 2013. Findings Of the transfers made, 28.1 percent were in the year 2012, 39.5 percent were in summer, 16.6 percent were in July, 17.9 percent were on Monday, 37.1 percent were between 12.00 and 17.59 h and 61.5 percent were from Gökçeada island. Ground ambulances were more common in the transfers from Bozcaada island, while ambulance boat and helicopter ambulance were more common for transfers from Gökçeada island. Helicopter-Emergency Medical Service (HEMS) (p<0.001), which is commonly preferred for patient transfers, inversely affects the use of Ambulance Boat-Emergency Medical Service (BEMS) and ground ambulances. Transfers from Bozcaada island were found to be shorter in duration, and the number of transfers from Bozcaada island between 00.00 and 05.59 h were found to be higher than from Gökçeada island (p<0.001), while the number of transfers via ground ambulance between 00.00 and 05.59 h were found to be higher than the other ambulance types (p<0.001). Practical implications This study reveals the current state of the various referral routes from the islands. Originality/value This paper is the first study to demonstrate the characteristics of patients referred from the island belongs to Turkey.

Two-Stage Covering Location Model for Air–Ground Medical Rescue System

This study tackled the multimodal facility location problem in emergency medical rescue. First, an intermodal setting was suggested, i.e., considering cooperation between ground ambulances and helicopters in emergency medical rescues. Specifically, four scheduling modes were structured: air only, ground only, air-ground combined mode if landing and take-off site for helicopters near the wounded is available, and air-ground transshipment if the landing and take-off site for helicopters near the wounded is not available. Second, a two-stage covering location model was proposed. In the first stage, a set-covering model was developed to achieve maximum coverage and minimal total construction cost of emergency rescue facilities. The optimal mixed allocation proportion of helicopters and ground ambulances was then obtained to guarantee cohesion between the hierarchical models and covering characteristics and the economic efficiency of location results. In the second stage, for given emergency locations, an emergency scheduling mode matrix was constructed for meeting response time and total rescue time constraints. The proposed model obtains optimal results in terms of coverage, construction cost, and rescue time. A case study of Beijing, China validated the feasibility and efficiency of the two-stage covering location model for multimodal emergency medical rescue network. The proposed air-ground rescue system and two-stage covering location model can be extended and also used for large-scale disaster rescue management.