Using geographic rescue time contours, point-of-care strategies, and spatial care paths to prepare island communities for global warming, rising oceans, and weather disasters
Open accessPublished version of a preprint
Abstract
Objectives: To perform geographic contour analysis of sea and land ambulance rescue times in an archipelago subject to super typhoons; to design point-of-care testing strategies for medical emergencies and weather disasters made more intense by global warming and rising oceans; and to assess needs for prehospital testing on spatial care paths that accelerate decision making, increase efficiency, improve outcomes, and enhance standards of care in island nations. Methods: We performed needs assessments, inspected healthcare facilities, and collected ambulance rescue times from professionals in the Bantayan Archipelago, Philippines. We mapped sea/land ambulance rescue routes and time contours. To reveal gaps, we statistically compared the fastest and slowest patient rescue times from islands/islets and barangays to the District Hospital on Bantayan Island. We developed spatial care paths (the fastest routes to care) for acute myocardial infarction, community care, and infectious diseases. We generated a compendium of prehospital diagnostic testing and integrated outcomes evidence, diagnostic needs, and public health goals to recommend point-of-care strategies that build geographic health resilience. Results: We observed limited access to COVID-19 assays, absence of blood gas/pH testing for critical care support, and spatial gaps in land and airborne rescues that worsened during inclement weather and sea swells. Mean paired differences (slowest-fastest) in ambulance rescue times to the District Hospital for both islands and barangays were significant (P < 0.0001). Spatial care path analysis showed where point-of-care cardiac troponin testing should be implemented for expedited care of acute myocardial infarction. Geospatial strengths comprised distributed primary care that can be facilitated by point-of-care testing, logical interisland transfers for which decision making and triage could be accelerated with onboard diagnostics, and healthcare networks amenable to medical advances in prehospital testing that accelerate treatment. Conclusions: Point-of-care testing should be positioned upstream close to homes and island populations that have prolonged rescue time contours. Geospatially optimized point-of-need diagnostics and distributed prehospital testing have high potential to improve outcomes. These improvements will potentially decrease disparities in mortality among archipelago versus urban dwellers, help improve island public health, and enhance resilience for increasingly adverse and frequent climate change weather disasters that impact vulnerable coastal areas. [350 words].
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The first systematic geospatial analysis for optimal positioning of POCT resources was conducted in a remote island setting, the Bantayan Archipelago, Visayas Islands, Philippines.
“The fi rst systematic geospatial analysis for optimal positioning of POCT resources was conducted in a remote island setting, the Bantayan Archipelago, Visayas Islands, Philippines [50].”
From Point-of-care testing: state-of-the art and perspectives (2025) · cites this paper as [50]
The Methods (Geospatial analysis; page not provided) describe rescue-time contour mapping in the Bantayan Archipelago to determine where to position POCT, and the Conclusions propose sites. Our copy does not establish that this was the first systematic geospatial analysis of its kind. (LLM, conf=0.86)
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Research works printed but not linked: 6
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- Authors
- Kost, G. J., Füzéry, A. K., Caratao, L. K. R., Tinsay, S., Zadran, A., & Ybañez, A. P.
- Affiliations
- University of California, Davis (US)
- University of Alberta (CA)
- Cebu Technological University (PH)
- Corresponding author
- Kost, Gerald J.
- Venue
- International Journal of Health Geographics
- Published
- 2023-12-20
- Volume
- 22
- Issue
- 1
- Pages
- 38-38
- ISSN
- 1476-072X (ISSN-L)
- PMC
- PMC10731708
- OpenAlex
- W4390002528
- Cited by
- 8
- References
- 67
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- International Journal of Health Geographics (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Fulbright U.S. Scholar Program
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Social Sciences › Sociology and Political Science › Disaster Management and Resilience
- Keywords
- point-of-care testing, island health, super typhoon, climate change adaptation, sea level rise, meteorological disasters, acute myocardial infarction, COVID-19 testing access, regional health disparities
- MeSH terms
- Disasters, Humans, Myocardial Infarction, Patient Care Planning, Weather, Point-of-Care Systems, Global Warming
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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