Acute cardiac care & resuscitation

Geographic inequalities in prehospital critical care for cardiac arrest: a spatial analysis of deprivation and service configuration

ResuscitationPublished spatial analysis

Authors' conclusion

Observed inequalities in prehospital critical care attendance are explained by spatial factors and the geographic configuration of services rather than deprivation alone. Optimising the location of prehospital critical care assets represents an opportunity to reduce inequalities.

Study context

Population
Out-of-hospital cardiac arrest (OHCA) patients treated by three neighbouring ambulance services in England between 2018 and 2023patients, covering 9,639 neighbourhoods
Participants
57,601 patients
Comparison
Relationship between neighbourhood deprivation and attendance of prehospital critical care teams to OHCA patients, accounting for the geographical distribution of prehospital critical care bases
Outcome
Prehospital critical care attendance
Methodological detailsthree neighbouring ambulance services in England, explicit spatial modelling
  • Three neighbouring ambulance services in England
  • Explicit spatial modelling

Main finding

As reported in the abstract

Median neighbourhood attendance

25.0%

Further findings

Distance to the nearest prehospital critical care base and attendance

Distance to the nearest prehospital critical care base was significantly associated with attendance

Spatial autocorrelation and clustering of attendance

Strong evidence of positive spatial autocorrelation and clustering of attendance

Neighbourhood deprivation and attendance after accounting for spatial dependence

Accounting for spatial dependence removed the association with neighbourhood deprivation
Clinical variables, distance to nearest prehospital critical care base and a daytime emergency call were the major drivers of attendance

Original publication

Geographic inequalities in prehospital critical care for cardiac arrest: a spatial analysis of deprivation and service configuration. Resuscitation. Published 11 April 2026. doi:10.1016/j.resuscitation.2026.111093

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