Document Type

Capstone Experience

Graduation Date

8-2022

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Dr. Sharon Medcalf, PhD

Second Committee Member

Tim Wilson, MBA, NRPS, EMSI, CLSSEGB

Third Committee Member

Leslie Scofield, MPH

Abstract

Timely EMS response and ground transport to the appropriate hospital are essential to patients’ survival and health outcomes during emergencies. This study utilizes interactive Geospatial Information System (GIS) mapping to assess emergency medical service (EMS) response and hospital arrival times in rural and urban Nebraska counties. The goal is to determine if there are underserved areas in the State and to propose potential interventions if identified. 2018 Social Vulnerability Index Scores (SVI) collected from Census Data were also reviewed for these areas to see possible correlations. The interactive GIS map revealed the Western and Central regions of Nebraska to be the most underserved. Specifically, the map identified numerous underserved counties, including Gage, Pierce, and Hitchcock. A pattern emerged that showed access to emergency services decreases as the urban percentage decreases since many of the rural counties are primarily served by volunteer responders. Also, no correlations between SVI and underserved areas were identified for Lancaster, Pierce, and Hitchcock counties, but Gage County had a strong, positive correlation. Proposed interventions for the underserved counties may include mobile stroke units, community paramedicine, stroke-ready certifications for rural hospitals, improved access to other forms of transportation for trauma patients in addition to ground transport, and using telemedicine when transportation is not available.

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