Academic Journal
Hierarchical Bayesian analysis of prehospital timelines for elderly adults in rural and urban motor-vehicle crashes.
| Τίτλος: | Hierarchical Bayesian analysis of prehospital timelines for elderly adults in rural and urban motor-vehicle crashes. |
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| Συγγραφείς: | Balyagati PF; Department of Civil and Environmental Engineering, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH 44115, United States. Electronic address: p.balyagati@vikes.csuohio.edu., Ngereza AS; Department of Civil and Environmental Engineering, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH 44115, United States. Electronic address: a.ngereza@vikes.csuohio.edu., Kidando E; Department of Civil and Environmental Engineering, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH 44115, United States. Electronic address: e.kidando@csuohio.edu., Owusu-Danquah J; School of Engineering and Technology, University of Washington Tacoma, Tacoma, WA 98402, United States. Electronic address: j.owusudanquah@csuohio.edu., Kitali A; School of Engineering and Technology, University of Washington Tacoma, Tacoma, WA 98402, United States. Electronic address: a.kitali@uw.edu., Kalambay P; Department of Transportation Studies, Texas Southern University, 3100 Cleburne Street, Houston, TX 77004, United States. Electronic address: panick.kalambay@tsu.edu. |
| Πηγή: | Journal of safety research [J Safety Res] 2026 Jun; Vol. 97, pp. 453-462. Date of Electronic Publication: 2026 Apr 28. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Pergamon Press Country of Publication: United States NLM ID: 1264241 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1247 (Electronic) Linking ISSN: 00224375 NLM ISO Abbreviation: J Safety Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: Elmsford, NY : Pergamon Press Original Publication: [Chicago] National Safety Council. |
| Ιατρικοί όροι (MeSH): | Accidents, Traffic*/statistics & numerical data , Emergency Medical Services*/statistics & numerical data , Rural Population*/statistics & numerical data , Urban Population*/statistics & numerical data, Humans ; Aged ; Bayes Theorem ; Time Factors ; Female ; Ohio ; Male ; Aged, 80 and over |
| Περίληψη: | Introduction: Emergency medical services (EMS) play a critical role in improving survival after road crashes by providing timely prehospital care. However, differences in EMS response and transport persist between rural and urban areas. Older adults, who make up a large share of rural populations, face additional risks due to frailty and comorbid conditions, yet studies focusing on their prehospital care remain limited. Method: This study analyzed linked EMS and crash data from Ohio (2018-2023) to evaluate prehospital timelines for older adults involved in motor vehicle crashes. Rural-urban classification was determined using Rural-Urban Commuting Area (RUCA) codes. A hierarchical Bayesian survival model was used to assess response, on-scene, and transport times jointly, with predictors including distance to emergency centers, weather, crash characteristics, and time of occurrence. Results: Findings revealed that greater distances to emergency centers, multi-patient crashes, adverse weather, and off-peak or weekend crashes were associated with prolonged EMS timelines. Older adults consistently experienced longer on-scene times, reflecting the added complexity of their assessment and management. Rural areas showed delays, underscoring regional differences in EMS care. Conclusions: These results highlight the need for targeted strategies to improve EMS performance for elderly crash victims, particularly in rural settings. This study offers valuable insights into mitigating variations in EMS availability, highlighting the critical roles of geographic proximity and community-level conditions in shaping emergency response effectiveness. Practical Applications: Strategies to reduce gaps should include optimizing EMS base locations, and tailoring prehospital protocols to the needs of older patients. These interventions can improve response efficiency and reduce preventable delays in critical care for elderly crash victims. (Published by Elsevier Ltd.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Emergency Medical Services; Emergency Response Performance; Older Adults; Prehospital Delays; Rural Health |
| Entry Date(s): | Date Created: 20260615 Date Completed: 20260615 Latest Revision: 20260615 |
| Update Code: | 20260616 |
| DOI: | 10.1016/j.jsr.2026.04.009 |
| PMID: | 42297497 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1879-1247 |
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| DOI: | 10.1016/j.jsr.2026.04.009 |