An assessment of the rural-urban differences in the crash response time and county-level crash fatalities in the United States.
The Journal of rural health · 2021-10-19 · Observational study
Abstract
PURPOSE: This study aimed to estimate the crash response times in rural and urban counties in the United States, their association with county-level crash fatalities, and identify spatial clusters of crash fatalities across the United States. METHODS: We analyzed data from the Fatality Analysis Reporting System (2010-2019). Data were aggregated at the county level across the contiguous United States. The selected counties (n = 3,108) were categorized as rural, micropolitan-urban, or metropolitan-urban using the 2013 rural-urban commuting area codes. The predictor variable was crash response time, and the outcome variable was county-level crash fatalities. Crash and county characteristics were used as potential confounders. We performed a spatial negative binomial regression analysis and reported the rate ratios of crash fatalities. We estimated the crude and adjusted fatality rates across all counties and identified clusters of crash fatalities across the United States. FINDINGS: As one migrates from urban to rural areas, crash response times became significantly increasingly longer. The Emergency Medical Service (EMS) notification to scene arrival time was most predictive of crash fatalities. A minute increase in the EMS notification to scene arrival time was associated with a 1%, 2%, and 5% increased fatality rate ratio in rural, micropolitan-urban, and metropolitan-urban counties, respectively. Although crash fatalities were lower in rural counties, the crash fatality rate was 3-fold higher in rural counties compared to metropolitan-urban counties. Significant clusters of crash fatality rates were heterogeneously distributed across the United States. CONCLUSION: Reducing crash response time may contribute to reducing crash fatalities across the United States.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Rural & remote · Time intervals · Urban
Related articles
- On-scene intravenous line insertion adversely impacts prehospital time in rural vehicular trauma. (Am Surg, 2008)
- Association Between Rurality and Mortality: Observational Study of Spanish and United States Prehospital Emergency Care Cohorts. (Healthcare (Basel), 2026)
- The association of crash response times and deaths at the crash scene: A cross-sectional analysis using the 2019 National Emergency Medical Service Information System. (J Rural Health, 2022)
- Association Between Emergency Medical Service Response Time and Motor Vehicle Crash Mortality in the United States. (JAMA Surg, 2019)
- Short-term outcome and differences between rural and urban trauma patients treated by mobile intensive care units in Northern Finland: a retrospective analysis. (Scand J Trauma Resusc Emerg Med, 2015)
- Factors Impacting Patient Outcomes Associated with Use of Emergency Medical Services Operating in Urban Versus Rural Areas: A Systematic Review. (Int J Environ Res Public Health, 2019)