Görkem Sariyer

An analysis of Emergency Medical Services demand: Time of day, day of the week, and location in the city

Objective Effective planning of Emergency Medical Services (EMS), which is highly dependent on the analysis of past data trends, is important in reducing response time. Thus, we aimed to analyze demand for these services based on time and location trends to inform planning for an effective EMS. Materials and methods Data for this retrospective study were obtained from the Izmir EMS 112 system. All calls reaching these services during first six months of 2013 were descriptively analyzed, based on time and location trends as a heat-map form. Results The analyses showed that demand for EMS varied within different time periods of day, and according to day of the week. For the night period, demand was higher at the weekend compared to weekdays, whereas for daytime hours, demand was higher during the week. For weekdays, a statistically significant relation was observed between the call distribution of morning and evening periods. It was also observed that the percentage of demand changed according to location. Among 30 locations, the five most frequent destinations for ambulances, which are also correlated with high population densities, accounted for 55.66% of the total. Conclusion The results of this study shed valuable light on the areas of call center planning and optimal ambulance locations of Izmir, which can also be served as an archetype for other cities.

Child Abuse and Neglect Among Children Who Drop Out of School: A Study in Izmir, Turkey

Child abuse and neglect (CAN), and dropping out of school have long been recognized as pervasive social problems globally, and Turkey is no exception. This study aims to explore the prevalence and incidence of CAN in children who drop out of school of Turkey, using the ISPCAN Child abuse Screening Tool, Childrens Version, which is an appropriate tool for multinational comparisons. Data from a convenience sample of children who drop out of school age 11, 13, and 16 from Izmir were collected either by interviews or by self-completion. The results show that, compared to children who do not drop out of school, children who drop out of school have higher rates of psychological and physical abuse and neglect within the family. This study not only highlights the need for preventive laws for CAN and dropping out of school, but also points to direction for future research.

Factors affecting length of stay in the emergency department: A research from an operational viewpoınt

ABSTRACT Background: Due to the persistent increase inpatient volumes of emergency departments, improving the timeliness of emergency care delivery has become more important from an operational viewpoint. Objectives: To determine the main factors affecting length of stay (LOS) in an ED of a large-scale training hospital. Methods: This was a retrospective study set in an urban ED. The outcome variable of the study was LOS; demographic, status-based, and time-based predictor variables were gender, age, arrival type, diagnosis, month, day of the week, and period of the day. The descriptive statistics are presented. The hypotheses of this study were tested with an independent group t-test and ANOVA. A multivariate linear regression model was built to identify the dependence of LOS on the predictor variables. Results: LOS significantly differed based on diagnosis, day of the week, and period of the day. Weekends and evening periods had higher ED volumes, and a decrease in mean LOS. In the regression model, with the exception of month, all predictor variables were observed to be significant. As a result it is concluded that understanding time based factors and preparing the staffing schedule according to these could improve the timeliness of emergency care delivery.

Does ambulance utilization differ between urban and rural regions: a study of 112 services in a populated city, Izmir

ObjectiveEmergency Medical Services (EMS) play an important role in health care systems, especially when well planned and well managed. The goal of this research was to characterize ambulance utilization rates and investigate associated factors. Such an analysis could make a contribution to operational planning of these services.Materials and methodsThe data for this study were taken from the Izmir emergency ambulance service, known as the 112 service because of its call number. Total emergency demand made during 2013 was analyzed, and the data were categorized according to four sub-categories: gender, age, rural-urban, and reason for the call. For each category, an analysis was made in terms of the absolute number of calls and a relative measure. Hypothesis testing and correlation analysis were used to investigate the differences between the demand for each category and to compare demand across categories.ResultsAlthough demand rates from males and females were very similar, a significant difference was observed in the daily utilization of these services by gender. The absolute number of calls from rural regions was less than for urban regions, but the rural regions had a higher proportion of calls (i.e., calls per 1000 people). Similarly, the absolute number of calls generated by the elderly was less than that generated by the young, but the elderly had a higher value in terms of relative measures. A medical condition was the most frequent reason for calls. A significant and positive relation was observed between male-female and elderly-young citizens, and there was a significant but negative relation between rural-urban demand.ConclusionThis study confirms that gender, age, and rural-urban distinctions are major factors that affect demand for these services and should therefore to be taken into consideration in operations management. It also highlights the need for a specific focus on rural regions and elderly citizens.

Utilizing mHealth Applications in Emergency Medical Services of Turkey

Emergency medical services (EMS) frequently deal with life-threatening situations. They aim to deliver services as early as possible to avoid inevitable outcomes. Due to time-sensitive conditions, EMS around the globe, including Turkey, needs to employ information technologies for better healthcare delivery. Mobile health, referred to as m-Health, currently plays a major role in different areas of the healthcare sector, including EMS. Various devices, tools, and functions of m-Health allow a significant decrease in response time to critical situations, as well as increasing the quality of treatment. The aim of this chapter is to present collective information about the utilization of m-Health in EMS of Turkey. This exploratory study gives an overview of the current state of m-Health interventions about EMS in Turkey and discusses the main challenges faced by both medical and nonmedical users. This study presents that electronic recording, global positioning system (GPS), telemedicine, mobile or smartphones, desktops, personal digital assistants (PDAs) or handheld computers, and wireless networks are commonly used in the domain of EMS in Turkey. However, m-Health utilization has not achieved a satisfactory level yet due to various factors such as priorities, cost, legal issues, knowledge, logistics, and technology literacy. Possible recommendations for addressing these factors include efforts to increase collaboration between public and private sectors, develop strategies by the government, raise public awareness by using promotion campaigns, provide technological support especially for elderly and women, and improve technology and health literacy.

Sizing capacity levels in emergency medical services dispatch centers: Using the newsvendor approach

Background: The increased volume in demand worldwide in the present day has led to the need for the establishment of effective ambulance services. As call centers have become the primary contact point between patients and emergency service providers, the planning of the call center has become a key task for administrators. Objectives: The aim of this study is to apply a widely used operations management method, the newsvendor model, for optimizing the capacity level in EMS call centers with a minimum cost in order to efficiently meet the calls arriving. Methods: Real‐life data from a call center for ambulance services in a major city in Turkey was used. We propose using the newsvendor model for optimizing this call centers capacity level based on the forecasts of periodic call volumes via basic methods. Results: Ambulance service call volumes vary during the day and weekday call profiles are different from weekends. By separating the analysis into weekdays and weekends and illustrating shorter time intervals within the days, call volume can be forecast. Taking not only the point forecast but also the variation of the forecast into account, the capacity level of each period can be planned in a cost‐effective way. Conclusions: This paper provides a basis for operation planning strategies of ambulance services by reconsidering the uncertainties of demand. The newsvendor model, which works well under parameter uncertainty, can be used in planning the capacities of health care services, especially when high service levels are required.