A Spatial Decision-Support Framework for Assessing Road Network Efficiency in Emergency Healthcare Accessibility: A Case Study of Eastern Province Cities, Saudi Arabia

Background: The pressure on emergency medical services (EMSs) has been exacerbated by increased urbanization and population growth in major Saudi cities such as Dammam, Al Khobar, and Dhahran. In this study, a spatial decision-support framework is proposed to determine the accessibility to ambulance services and hospitals. Methods: Within the spatial decision-support framework, modeled two-leg travel time (station-to-scene plus scene-to-hospital, including modeled traffic-signal delays) is evaluated under both peak and non-peak traffic conditions, using a 30 min travel-time threshold. The model comprises road network data, ambulance and hospital locations, and traffic conditions to evaluate the travel component of emergency healthcare accessibility and to identify areas that are disadvantaged. Times for dispatch, ambulance response, scene assessment and treatment, stabilization, and loading are not included. Results: The results reveal significant spatial and temporal disparities, with accessibility decreasing during peak hours. Al Khobar has relatively better accessibility, while Dammam is consistently and significantly underserved, and Dhahran has moderate access. Taking into account the population data, it is evident that unequal accessibility is due to both spatial and demographic factors, with a significant number of residents having poor access to EMS. Conclusions: The findings can inform the improvement of EMS planning and people’s access to equitable healthcare. The framework can support the connection of underserved areas and direct development in the spatial distribution of emergency healthcare services.