Potential Access to Emergency General Surgical Care in Ontario

Jordan Nantais (), Kristian Larsen, Graham Skelhorne-Gross, Andrew Beckett, Brodie Nolan and David Gomez
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Jordan Nantais: Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
Kristian Larsen: CAREX Canada, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6T 1Z3, Canada
Graham Skelhorne-Gross: Department of Surgery, Division of General Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
Andrew Beckett: Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
Brodie Nolan: Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada
David Gomez: Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada

IJERPH, 2022, vol. 19, issue 21, 1-8

Abstract: Limited access to timely emergency general surgery (EGS) care is a probable driver of increased mortality and morbidity. Our objective was to estimate the portion of the Ontario population with potential access to 24/7 EGS care. Geographic information system-based network-analysis was used to model 15-, 30-, 45-, 60-, and 90-min land transport catchment areas for hospitals providing EGS care, 24/7 emergency department (ED) access, and/or 24/7 operating room (OR) access. The capabilities of hospitals to provide each service were derived from a prior survey. Population counts were based on 2016 census blocks, and the 2019 road network for Ontario was used to determine speed limits and driving restrictions. Ninety-six percent of the Ontario population ( n = 12,933,892) lived within 30-min’s driving time to a hospital that provides any EGS care. The availability of 24/7 EDs was somewhat more limited, with 95% ( n = 12,821,747) having potential access at 30-min. Potential access to all factors, including 24/7 ORs, was only possible for 93% ( n = 12,471,908) of people at 30-min. Populations with potential access were tightly clustered around metropolitan centers. Supplementation of 24/7 OR capabilities, particularly in centers with existing 24/7 ED infrastructure, is most likely to improve access without the need for new hospitals.

Keywords: emergency general surgery; potential access; access to care; health care models; geographic information system; rural surgery (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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