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Geospatial mapping of surgical systems for earthquake emergency planning in Guerrero, Mexico : an ecological study

Campos, Letícia Nunes ; Bryce-Alberti, Mayte ; Hill, Sarah K. ; del Valle, Diana D. ; Zaigham, Mehreen LU orcid ; Rábago, Alberto de la Rosa ; Dey, Tanujit ; Juran, Sabrina and Uribe-Leitz, Tarsicio (2023) In Lancet regional health. Americas 26. p.1-12
Abstract

BACKGROUND: Accessibility to surgical services can impact earthquake preparedness and response. We aimed to estimate the population with timely access to surgical care in Guerrero, a Mexican state with high tectonic activity, and identify populations at risk in the event of an earthquake.

METHODS: We conducted an ecological study using open government data. We extracted data from Guerrero municipalities regarding their earthquake risk, social vulnerability, social inequality, marginalisation, and resilience indices. The latest combines municipalities' resistance to unexpected events and capacity to maintain optimal functionality without immediate federal or international support. Geographical coordinates of active public and... (More)

BACKGROUND: Accessibility to surgical services can impact earthquake preparedness and response. We aimed to estimate the population with timely access to surgical care in Guerrero, a Mexican state with high tectonic activity, and identify populations at risk in the event of an earthquake.

METHODS: We conducted an ecological study using open government data. We extracted data from Guerrero municipalities regarding their earthquake risk, social vulnerability, social inequality, marginalisation, and resilience indices. The latest combines municipalities' resistance to unexpected events and capacity to maintain optimal functionality without immediate federal or international support. Geographical coordinates of active public and private surgical facilities in Guerrero were combined with ancillary spatial data on roads and municipalities' population density to estimate population coverage within 30-min and 1-h driving time to surgical facilities in Redivis. We built an ordered beta regression model for each driving time estimate.

FINDINGS: We identified 25 public and 16 private facilities capable of providing surgical care in Guerrero. The population with access to facilities with surgical capacity within 30 min and 1-h driving times were 48.4% and 69.1%, respectively. We found that municipalities with very high levels of earthquake risk, social vulnerability, social inequality, and marginalisation, and very low levels of resilience had decreased coverage. In the multivariable analysis, the resilience index was statistically significant only for the 30-min model, with an effect size of 0.524 (95% CI 0.082, 1.089).

INTERPRETATION: Access to surgical care remains unequally distributed in Guerrero municipalities at the highest risk for earthquakes. Municipalities' resilience was the most significant predictor of higher surgical care coverage in 30-min driving time. Our study provides insights on how surgical system strengthening can enhance earthquake emergency disaster planning.

FUNDING: No funding.

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Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Disaster planning, Emergency service, Geographic mapping, Global health, Health policy, Hospital, Natural disasters
in
Lancet regional health. Americas
volume
26
article number
100586
pages
1 - 12
publisher
Elsevier
external identifiers
  • scopus:85171549348
  • pmid:37701459
  • pmid:37701459
ISSN
2667-193X
DOI
10.1016/j.lana.2023.100586
language
English
LU publication?
yes
id
be03722f-2978-4953-b8c0-67f8e4f33a38
date added to LUP
2023-09-18 18:36:35
date last changed
2024-04-19 01:23:58
@article{be03722f-2978-4953-b8c0-67f8e4f33a38,
  abstract     = {{<p>BACKGROUND: Accessibility to surgical services can impact earthquake preparedness and response. We aimed to estimate the population with timely access to surgical care in Guerrero, a Mexican state with high tectonic activity, and identify populations at risk in the event of an earthquake.</p><p>METHODS: We conducted an ecological study using open government data. We extracted data from Guerrero municipalities regarding their earthquake risk, social vulnerability, social inequality, marginalisation, and resilience indices. The latest combines municipalities' resistance to unexpected events and capacity to maintain optimal functionality without immediate federal or international support. Geographical coordinates of active public and private surgical facilities in Guerrero were combined with ancillary spatial data on roads and municipalities' population density to estimate population coverage within 30-min and 1-h driving time to surgical facilities in Redivis. We built an ordered beta regression model for each driving time estimate.</p><p>FINDINGS: We identified 25 public and 16 private facilities capable of providing surgical care in Guerrero. The population with access to facilities with surgical capacity within 30 min and 1-h driving times were 48.4% and 69.1%, respectively. We found that municipalities with very high levels of earthquake risk, social vulnerability, social inequality, and marginalisation, and very low levels of resilience had decreased coverage. In the multivariable analysis, the resilience index was statistically significant only for the 30-min model, with an effect size of 0.524 (95% CI 0.082, 1.089).</p><p>INTERPRETATION: Access to surgical care remains unequally distributed in Guerrero municipalities at the highest risk for earthquakes. Municipalities' resilience was the most significant predictor of higher surgical care coverage in 30-min driving time. Our study provides insights on how surgical system strengthening can enhance earthquake emergency disaster planning.</p><p>FUNDING: No funding.</p>}},
  author       = {{Campos, Letícia Nunes and Bryce-Alberti, Mayte and Hill, Sarah K. and del Valle, Diana D. and Zaigham, Mehreen and Rábago, Alberto de la Rosa and Dey, Tanujit and Juran, Sabrina and Uribe-Leitz, Tarsicio}},
  issn         = {{2667-193X}},
  keywords     = {{Disaster planning; Emergency service; Geographic mapping; Global health; Health policy; Hospital; Natural disasters}},
  language     = {{eng}},
  pages        = {{1--12}},
  publisher    = {{Elsevier}},
  series       = {{Lancet regional health. Americas}},
  title        = {{Geospatial mapping of surgical systems for earthquake emergency planning in Guerrero, Mexico : an ecological study}},
  url          = {{http://dx.doi.org/10.1016/j.lana.2023.100586}},
  doi          = {{10.1016/j.lana.2023.100586}},
  volume       = {{26}},
  year         = {{2023}},
}