Evaluation of inter-facility medical transport journey times in Southeastern British Columbia

Abstract: Very sick patients who need specialized health services often require transport from their community to a regional facility that is appropriately resourced to provide definitive care for their condition. This is particularly important for people living in rural and remote areas but can be challenging due to long distances, mountainous terrain and inclement weather. The purpose of this research was to improve health service delivery to rural communities within the study area by identifying whether or not there were inter-facility medical transport routes within the study area with highly variable or unexpectedly long journey times. Select transport characteristics were examined to further inform decision making related to acute inter-facility transport within the study area. The medical records of 418 high acuity patient transports within Southeastern British Columbia were reviewed in order to capture information about ‘observed’ transport times, locations, and other transport characteristics. A geographic network analysis of each route identified within the study dataset was conducted in order to estimate ‘expected’ transport times. These expected transport times, in addition to GoogleMap time estimates, were compared to observed transport times to determine areas of possible concern within the transport network. A multiple regression analysis was conducted to identify predictors of transport times. Observed transport times in the study dataset were generally found to be within a statistically acceptable range of expected transport time estimates. The only transports with significantly longer than expected journey times were due to ‘meets’ in transport. Additional factors such as patients’ clinical categories, mode of transport, and max elevation en-route were predictive of transport times within the study context.