April 5, 2011One ride could be the difference between life and death. That is the lesson recent University of Alabama graduate Daniel Marbury learned by studying ambulance response times in Alabama as part of a student research project he conducted at the College’s Institute for Rural Health Research. By measuring the disparity between ambulance services in rural and urban areas, Marbury found that the balance between life and death could hinge on an ambulance ride in medical emergencies – and, it may not tilt in favor of rural Alabamians. Using statistical analysis to study the timed responses of ambulance services in three public health areas, Marbury found that rural Alabamians are at a disadvantage for receiving treatment in the event of an emergency. The project measured ambulance response times by gauging the time from ambulance call to the emergency site and from the site to a primary care facility. Marbury compared three different public health areas: one that included Jefferson County, one with Tuscaloosa County, and an area south of Tuscaloosa encompassing eight rural Black Belt counties, a region named for the color of its soil. Ambulance travel times are reported by emergency medical personnel every time an emergency call is received. Marbury’s analysis considered both response and transport times. Response time is defined as the time it takes for an ambulance to arrive on the scene of the emergency after receiving notification from 911, while transport time is measured from the time an ambulance leaves the site with the patient to the time of arrival at a primary care facility such as a hospital. Marbury, of Alpharetta, Georgia, majored in political science and music, and his research project was conducted through his membership in the University’s Computer-Based Honors Program. “I was most interested in picking up the skills used in database management,” he says. “It seemed like a very practical experience that would apply in future research efforts. Additionally, this project had such direct and meaningful implications for Alabamians.” Marbury’s study utilized data from the Alabama Department of Public Health EMS database, which is part of a larger National EMS Information System. Information from every response to a 911 call is stored in these databases, with more than 200 variables used to describe the procedures that occur during each emergency. Marbury, who graduated in May, found that the average response time for urban and rural areas was relatively the same, but rural counties had a significantly longer average time for transport to a primary care facility. “We saw a difference between an average of 12 minutes and 42 seconds in Jefferson County and 19 minutes and 8 seconds in the rural public health area 7. The likely explanation for this difference is that there are fewer hospitals servicing rural areas,” Marbury says. Daniel Marbury, right, talks with paramedic Chris Roberts. Lea Yerby, PhD, an assistant professor in the College’s Institute for Rural Health Research and Department of Community and Rural Medicine and Marbury’s adviser for his ambulance time research, says, “These differences could have a major impact on survivability and trauma care outcomes for people who live in rural areas.” Yerby has used Marbury’s research to not only measure response time, but also to determine how long an ambulance unit is on the scene, as well as transport time. She found there were significant differences between all three public health areas for on-scene time, transport time and total time from beginning to end. Marbury became interested in the research project when he received an e-mail from the Computer-Based Honors Program about possible summer employment options. He began working on the database management project with Jason Parton, MS, MA, director of special projects for the Institute for Rural Health Research, and decided to continue this work as his Computer-Based Honors Program research project. Marbury has mentored another Computer-Based Honors Program student, Gaines Gibson, who is continuing the research.