The role of health expenditures and education level of the population in the intensity of emergency medicine service (EMS)


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DOI:

https://doi.org/10.26900/hsq.2764

Keywords:

Emergency medical services, health expenditure, education, literacy, public health, healthcare utilization

Abstract

This study examines the impact of education and healthcare expenditures on emergency medicine service (EMS) usage in Türkiye (2002–2023). It explores how literacy, school enrolment, and public healthcare spending influence EMS demand. Lower literacy and enrolment may increase emergency visits, reducing EMS efficiency. Public healthcare spending improves primary care, easing EMS congestion, while private healthcare spending may increase EMS use through easier access. A descriptive and relational scanning model was used to categorize EMS utilization per 100,000 populations. Data on EMS use, education and healthcare expenditures were collected from official sources. Pearson correlation, multiple regression and year controlled partial correlation were applied. The R squared value confirmed model fit and identified education and healthcare spending as key EMS predictors. Limitations include aggregated data and untested factors. Future research should explore the relations hip between socioeconomic status and healthcare infrastructure. Primary school enrolment negatively correlated with EMS use (r=-0.890, p<0.01), while literacy rate had a positive correlation (r=0.992, p<0.01). Public healthcare spending reduced EMS demand, but regression analysis indicated that literacy rate was the strongest predictor of EMS utilization (B=142.13, p<0.01). Education significantly influences EMS use. Higher literacy rates increase EMS utilization, while school enrolment reduces it. Strengthening health literacy and primary care can enhance EMS effectiveness.

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References

Ty D, Gruber M, Klein N, Branzetti J, Brown M, McCarty M, et al. An observation medicine curriculum for emergency medicine education. J Educ Teach Emerg Med. 2021;6(2):C1–C72. doi: 10.21980/J87P92. DOI: https://doi.org/10.5070/M562052906

Luke C, Kadzombe E, Gorman D, A Armstrong. An evaluation of a logbook for trainees in accident & emergency medicine in the United Kingdom: Senior consultant opinion. Arch Emerg Med. 1993;10(1):43-7. doi: 10.1136/emj.10.1.43. DOI: https://doi.org/10.1136/emj.10.1.43

Thakali K, Ulak N, Bharati M, Thapa LJ, Paudyal DN, Basnet CK, et al. Poisoning among patients presenting to the department of emergency medicine of a tertiary care centre: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2022;60(254):861-4. doi: 10.31729/jnma.7878. DOI: https://doi.org/10.31729/jnma.7878

Pek JH, Lim SH, Ho HF, Ramakrishnan TV, Jamaluddin SF, Mesa-Gaerlan FJC, et al. Emergency medicine as a specialty in Asia. Acute Med Surg. 2015;3(2):65-73. doi: 10.1002/ams2.154. DOI: https://doi.org/10.1002/ams2.154

Vista FES, Alibin MPA, Arevalo MPTN, Gaerlan FJM. Emergency medicine research in the Philippines: A scoping review. J Am Coll Emerg Physicians Open. 2023;4(4):e13008. doi: 10.1002/emp2.13008. DOI: https://doi.org/10.1002/emp2.13008

Shah R, Della Porta A, Leung S, Samuels-Kalow M, Schoenfeld EM, Richardson LD, et al. A scoping review of current social emergency medicine research. West J Emerg Med. 2021;22(6):1360-8. doi: 10.5811/westjem.2021.4.51518. DOI: https://doi.org/10.5811/westjem.2021.4.51518

Yiadom MYAB, McWade CM, Awoonor-Williams K, Appiah-Denkyira E, Moresky RT. Public health rationale for investments in emergency medicine in developing countries – Ghana as a case study. J Emerg Med. 2018;55(4):537- 43. doi: 10.1016/j.jemermed.2018.07.021. DOI: https://doi.org/10.1016/j.jemermed.2018.07.021

Le Bel J, Pelaccia T, Ray P, Mayaud C, Brun AL, Hausfater P, et al. Impact of emergency physician experience on decision-making in patients with suspected community-acquired pneumonia and undergoing systematic thoracic CT scan. Emerg Med J. 2019;36(8):485-92. doi: 10.1136/emermed-2018-207842. DOI: https://doi.org/10.1136/emermed-2018-207842

Crilly J, Johnston AN, Wallis M, O'Dwyer J, Byrnes J, Scuffham P, et al. Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study. Emerg Med Australas. 2020;32(2):271-80. doi: 10.1111/1742-6723.13407. DOI: https://doi.org/10.1111/1742-6723.13407

Talebi M, Talebi Doluee M, Jafari M, Zamani Moghaddam H, Foroughian M, Moazzami M, et al. Comparing the emergency medicine residency programs in Iran and around the world: A descriptive study. Arch Acad Emerg Med. 2023;11(1):e13. doi: 10.22037/aaem.v11i1.1867.

Galletta G, Løvstakken K. Emergency medicine in Norway: The road to specialty recognition. J Am Coll Emerg Physicians Open. 2020;1(5):790-4. doi: 10.1002/emp2.12197. DOI: https://doi.org/10.1002/emp2.12197

Crilly J, Huang YL, Krahe M, Wilhelms D, Ekelund U, Hörlin E, et al. Research priority setting in emergency care: A scoping review. J Am Coll Emerg Physicians Open. 2022;3(6):e12852. doi: 10.1002/emp2.12852. DOI: https://doi.org/10.1002/emp2.12852

Yu S, Guo X, Li G, Yang H, Zheng L, Sun Y. Low educational status correlates with a high incidence of mortality among hypertensive subjects from Northeast Rural China. Front Public Health. 2022;10:951930. doi: 10.3389/fpubh.2022.951930. DOI: https://doi.org/10.3389/fpubh.2022.951930

Notara V, Panagiotakos DB, Kogias Y, Stravopodis P, Antonoulas A, Zombolos S, et al. The impact of educational status on 10-year (2004–2014) cardiovascular disease prognosis and all-cause mortality among acute coronary syndrome patients in the Greek acute coronary syndrome (GREECS) longitudinal study. J Prev Med Public Health. 2016;49(4):220-9. doi: 10.3961/jpmph.16.005. DOI: https://doi.org/10.3961/jpmph.16.005

Rasmussen ZA, Shah WH, Hansen CL, Azam SI, Hussain E, Schaefer BA, et al. Examining the relationships between early childhood experiences and adolescent and young adult health status in a resource-limited population: A cohort study. PLoS Med. 2021;18(9):e1003745. doi: 10.1371/journal.pmed.1003745. DOI: https://doi.org/10.1371/journal.pmed.1003745

Pförtner TK, Dohle S, Hower KI. Trends in educational disparities in preventive behaviours, risk perception, perceived effectiveness and trust in the first year of the COVID-19 pandemic in Germany. BMC Public Health. 2022;22(1):903. doi: 10.1186/s12889-022-13341-3. DOI: https://doi.org/10.1186/s12889-022-13341-3

Dienhart C, Paulweber B, Frey VN, Iglseder B, Trinka E, Langthaler P, et al. Inverse association between educational status and coronary CT calcium scores: should we reflect this in our ASCVD risk assumptions? Int J Environ Res Public Health. 2023;20(12):6065. doi: 10.3390/ijerph20126065. DOI: https://doi.org/10.3390/ijerph20126065

Weinberg D, Stevens GWJM, Finkenauer C, Brunekreef B, Smit HA, Wijga AH. The pathways from parental and neighbourhood socioeconomic status to adolescent educational attainment: An examination of the role of cognitive ability, teacher assessment, and educational expectations. PLoS One. 2019;14(5):e0216803. doi: 10.1371/journal.pone.0216803. DOI: https://doi.org/10.1371/journal.pone.0216803

Pek JH, Low JW, Lau TP, Gan HN, Phua DH. Emergency medicine residency training during COVID-19. Singapore Med J. 2022;63(8):473-7. doi: 10.11622/smedj.2020139. DOI: https://doi.org/10.11622/smedj.2020139

Zou Y, Jia L, Chen S, Deng X, Chen Z, He Y, et al. Spatial accessibility of emergency medical services in Chongqing, Southwest China. Front Public Health. 2023;11:959314. doi: 10.3389/fpubh.2022.959314. DOI: https://doi.org/10.3389/fpubh.2022.959314

Ventura CAI, Denton EE, David JA, Schoenfelder BJ, Mela L, Lumia RP, et al. Emergency medical services prehospital response to the COVID-19 pandemic in the US: a brief literature review. Open Access Emerg Med. 2022;14:249-72. doi: 10.2147/OAEM.S366006. DOI: https://doi.org/10.2147/OAEM.S366006

Thinnes R, Swanson MB, Wetjen K, Harland KK, Mohr NM. Preferences for emergency medical service transport after childhood injury: An emergency department-based multi-methods study. Injury. 2020;51(9):1961-9. doi: 10.1016/j.injury.2020.04.036. DOI: https://doi.org/10.1016/j.injury.2020.04.036

Bhattarai HK, Bhusal S, Barone-Adesi F, Hubloue I. Prehospital emergency care in low- and middle-income countries: A systematic review. Prehosp Disaster Med. 2023;38(4):495-512. doi: 10.1017/S1049023X23006088. DOI: https://doi.org/10.1017/S1049023X23006088

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Published

2025-10-04

How to Cite

Boğa, E. (2025). The role of health expenditures and education level of the population in the intensity of emergency medicine service (EMS). Health Sciences Quarterly, 5(4), 443–52. https://doi.org/10.26900/hsq.2764

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