From accident to hospital: measuring inequality in pre-hospital emergency services in a city in the North of Iran

• Date: 24 August 2021
• Pages: 254-263
• DOI: https://doi.org/10.1108/IJHRH-05-2021-0121
• Published date: 24 August 2021
• Subject Matter: Health & social care,Vulnerable groups,Inequalities & diverse/minority groups,Sociology,Race & ethnic studies,Minorities,Multiculturalism,Racial identity,Work,economy & organizations
• Author: Mohaddese Omidi,Behzad Zohrevandi,Enayatollah Homaie Rad

From accident to hospital: measuring

inequality in pre-hospital emergency

services in a city in the North of Iran

Mohaddese Omidi, Behzad Zohrevandi and Enayatollah Homaie Rad

Abstract

Purpose –As a human right, people need to arriveearly at the hospitals when they are injured in traffic

accidents. Both the mean and equality of the time of arriving at the hospital are important. This study

aimed to investigate inequality in arrival time of emergent traffic accident patients to the hospital in

2018–2019in a city in the North of Iran.

Design/methodology/approach –The authors extracted the data from the Guilan province trauma

system databank in Poursina Hospital in Rasht in 2018 and 2019. The Gini coefficient was used to

calculate inequality, anda regression model was estimated for determining thereason for inequality in

time to receivehospital services.

Findings –The study showedthat patients’ arrival time from the time ofthe accident to the time of arrival

to the hospital was 64.48 647.63 min (minimum of 9 min and maximum 462 min). Gini coefficient was 0.31

(p <0.001), which does not show high inequality. Regression results showed that the transfer time of

patients by car was 40 min longer (p-value <0.001) than ambulances (p= 0.036). In children, the transfer

time was 42min less (p = 0.003). Other variables did not explain the inequality(p >0.05).

Originality/value –According to the time of arrival of patients and Gini index, in Rasht, inequality in

providing services is not in a bad condition. This indicates that the emergency department does not

systematicallytransport people to the hospitallate.

Keywords Iran, Inequality, GINI index, Prehospital emergency services

Paper type Research paper

Abbreviations

EMS = emergency medical services;

AIDS = acquired immune def‌iciency syndrome;

NAM = National Academy of Medicine;

IOM = Medical Institute;

GDP = gross domestic product; and

CI = concentration index.

Background

Prehospital emergency care is responsible for care before the patient arrives in the hospital

(Aboueljinane et al., 2013;Heydari et al.,2017). In Iran, up to 30 million missions are

performed annually in 4,500 prehospital emergency bases, of which about 15% of these

missions are related to trauma patients in traffic accidents. In Iran, the accident mortality is

higher than the total mortality of AIDS, tuberculosis and malaria. In Iran, 9% of the total

mortality and 12% of the burden of diseases are due to accidents, especially traffic

accidents (hadian et al.,2020). The goal of the prehospital emergency is to provide

effective and accessible emergency care to all those who need it, which can be done by

Mohaddese Omidi is based

at the Student Research

Committee, Guilan Road

Trauma Research Center,

Guilan University of Medical

Sciences, Rasht, Iran.

Behzad Zohrevandi is

based at the Guilan Road

Trauma Research Center,

Guilan University of Medical

Sciences, Rasht, Iran.

Enayatollah Homaie Rad is

based at the Social

Determinants of Health

Research Center, Guilan

University of Medical

Sciences, Rasht, Iran.

Received 28 May 2021

Revised 1 August 2021

Accepted 7 August 2021

This study was derived from the

MD thesis of Mohaddese

Omidi. Authors thank to Guilan

Road Trauma Research Center

for its financial supports.

PAGE 254 jINTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE jVOL. 16 NO. 3 2023, pp. 254-263, ©EmeraldPublishing Limited, ISSN 2056-4902DOI 10.1108/IJHRH-05-2021-0121