Endogeneity of pedestrian survival time and emergency medical service response time: Variations across disadvantaged and non-disadvantaged communities

IF 5.7 1区工程技术 Q1 ERGONOMICS

Accident; analysis and prevention Pub Date : 2024-10-01 DOI:10.1016/j.aap.2024.107799

A. Latif Patwary , Asad J. Khattak

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引用次数: 0

Abstract

The Vision Zero-Safe Systems Approach prioritizes fast access to Emergency Medical Services (EMS) to improve the survivability of road users in transportation crashes, especially concerning the recent increase in pedestrian-involved crashes. Pedestrian crashes resulting in immediate or early death are considerably more severe than those taking longer. The time gap between injury and fatality is known as survival time, and it heavily relies on EMS response time. The characteristics of the crash location may be associated with EMS response and survival time. A US Department of Transportation initiative identifies communities often facing challenges. Six disadvantaged community (DAC) indicators, including economy, environment, equity, health, resilience, and transportation access, enable an analysis of how survival and EMS response times vary across DACs and non-DACs. To this end, this study created a unique and comprehensive database by linking DACs data with 2017–2021 pedestrian-involved fatal crashes. This study utilizes two-stage residual inclusion models with segmentation for DACs and non-DACs accounting for the endogenous relationship between EMS response and pedestrian survival time. The results indicate that EMS response time is higher and pedestrian survival time is lower in DACs than in non-DACs. A delayed EMS response time is associated with a greater reduction in survival time in DACs compared to non-DACs. Factors, e.g., nighttime and interstate crashes, contribute to higher EMS response time, while pedestrian drugs, driver speeding, and hit-and-run behaviors are associated with a greater reduction in survival time in DACs than non-DACs. The implications of the findings are discussed in the paper.

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行人存活时间和紧急医疗服务响应时间的内生性：弱势社区与非弱势社区之间的差异。

零伤亡愿景-安全系统方法优先考虑快速获得紧急医疗服务（EMS），以提高交通事故中道路使用者的存活率，尤其是最近涉及行人的交通事故的增加。与时间较长的交通事故相比，导致行人立即或提前死亡的交通事故要严重得多。受伤与死亡之间的时间差被称为存活时间，它在很大程度上取决于急救服务的响应时间。撞车地点的特征可能与急救响应和存活时间有关。美国交通部的一项倡议确定了经常面临挑战的社区。六项弱势社区 (DAC) 指标（包括经济、环境、公平、健康、复原力和交通便利性）有助于分析 DAC 和非 DAC 社区的存活率和急救响应时间有何不同。为此，本研究通过将 DACs 数据与 2017-2021 年涉及行人的致命车祸联系起来，创建了一个独特而全面的数据库。本研究采用两阶段残差包含模型，对 DAC 和非 DAC 进行细分，以考虑 EMS 响应与行人存活时间之间的内生关系。结果表明，与非危险货物运输中心相比，危险货物运输中心的急救响应时间更长，行人存活时间更短。与非危险区域相比，紧急医疗服务响应时间的延迟与危险区域行人存活时间的缩短有更大的关联。夜间和州际碰撞等因素会导致更长的急救响应时间，而行人吸毒、驾驶员超速和肇事逃逸行为则会导致危险驾驶区域的存活时间比非危险驾驶区域缩短更多。本文讨论了这些发现的意义。

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

Accident; analysis and prevention Multiple-

CiteScore

11.90

自引率

16.90%

发文量

264

审稿时长

48 days

期刊介绍： Accident Analysis & Prevention provides wide coverage of the general areas relating to accidental injury and damage, including the pre-injury and immediate post-injury phases. Published papers deal with medical, legal, economic, educational, behavioral, theoretical or empirical aspects of transportation accidents, as well as with accidents at other sites. Selected topics within the scope of the Journal may include: studies of human, environmental and vehicular factors influencing the occurrence, type and severity of accidents and injury; the design, implementation and evaluation of countermeasures; biomechanics of impact and human tolerance limits to injury; modelling and statistical analysis of accident data; policy, planning and decision-making in safety.