Relationship between geographic accessibility to emergency services and infant mortality: A systematic review and meta-analysis

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health Pub Date : 2024-08-01 DOI:10.1111/jpc.16627

Patrícia Meireles Brito, Katia Suely Queiroz Silva Ribeiro, Renato S Melo, Afonso Rodrigues Tavares Netto, Silvia Wanick Sarinho

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引用次数: 0

Abstract

Aim

To evaluate the methodological quality of studies that analysed the relationship between accessibility to emergency services and infant mortality.

Methods

A systematic review with meta-analysis, registered on the international prospective register of systematic reviews (PROSPERO) platform under code CRD42021279854. Medline/Pubmed, Embase, SciElo, Lilacs, Scopus and web of science electronic databases were searched between November 2021 and May 2024, without language or publication time restriction. We included observational studies that compared the infant mortality outcome with the different distances travelled or travel time to health services in a paediatric emergency. Thus, we excluded studies with primary outcomes present in the pre- and perinatal periods, as well as distances or travel time to obstetric emergency units. We used the grade to assess the methodological quality of the studies and the Newcastle-Ottawa scale for the risk of bias, in addition to performing a meta-analysis.

Results

The evidence quality on infant mortality was moderate for four studies and low for three studies. The meta-analysis showed that children who travelled more than 5 km to the emergency service had a 28% increase in the chance of dying (P = 0.002), as well as those travelling for more than 40 min increased by 45% (P < 0.001).

Conclusions

There was a relationship between the increase in geographic accessibility distance and travel time with the increase in infant mortality. However, the studies still showed moderate to low methodological quality.

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急救服务的地理可达性与婴儿死亡率之间的关系：系统回顾和荟萃分析。

目的：评估分析急救服务可及性与婴儿死亡率之间关系的研究的方法质量：在国际系统综述前瞻性注册平台（PROSPERO）上注册的系统综述与荟萃分析，代码为 CRD42021279854。我们在 2021 年 11 月至 2024 年 5 月期间检索了 Medline/Pubmed、Embase、SciElo、Lilacs、Scopus 和 web of science 等电子数据库，没有语言或出版时间限制。我们纳入的观察性研究比较了在儿科急诊中婴儿死亡率与不同的旅行距离或到达医疗服务机构的旅行时间之间的关系。因此，我们排除了主要结果出现在产前和围产期，以及前往产科急诊室的距离或旅行时间的研究。除了进行荟萃分析外，我们还使用了等级来评估研究的方法学质量，并使用纽卡斯尔-渥太华量表来评估偏倚风险：结果：四项研究的婴儿死亡率证据质量为中度，三项研究的婴儿死亡率证据质量为低度。荟萃分析表明，前往急救中心的路程超过 5 公里的儿童死亡几率增加了 28%（P = 0.002），而路程超过 40 分钟的儿童死亡几率增加了 45%（P 结论：荟萃分析表明，前往急救中心的路程超过 5 公里的儿童死亡几率增加了 28%（P = 0.002），而路程超过 40 分钟的儿童死亡几率增加了 45%（P = 0.003）：地理可达距离和旅行时间的增加与婴儿死亡率的增加之间存在关系。不过，这些研究的方法学质量仍处于中下水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.