Golden Hour Divide: Trauma Care Accessibility and Resource Vulnerability in Sri Lanka
2026-06-29 • Machine Learning
Machine Learning
AI summaryⓘ
The authors studied how well emergency intensive care services are available across Sri Lanka’s 25 districts. They found that many areas, especially in the Northern and Eastern provinces, lack timely access to specialists and resources needed to treat critical conditions quickly. Using detailed geographic and health data, they grouped districts into four types based on their healthcare challenges. The study highlights that the shortage of specialists, not beds, is the main problem and suggests that improving access in certain areas could significantly reduce unmet medical needs. This work offers guidance for better distributing healthcare specialists to improve emergency care equity.
intensive careemergency infrastructureH3 hexagonal modelingK-Means clusteringGolden Hourpre-hospital servicesclinical demandresource availabilityhealthcare equitySri Lanka
Authors
Sonath Kirindage, Vihanga Nimsara, Sakindu Rajapaksa, Kavyanga Hathurusinghe, Lahiru Dilshan, Subavarshana Arumugam, Nathali Athukorala, Sandareka Wickramanayake, Nisansa de Silva
Abstract
Timely intensive care dictates survival, yet emergency infrastructure remains unevenly distributed across Sri Lanka. While pre-hospital services have expanded, the transition to definitive care remains a critical bottleneck. This study evaluates national emergency resilience by quantifying the gap between clinical demand and the availability of specialized resources across all 25 districts. Using the latest national epidemiological data and terrain-aware H3 hexagonal modeling, we analyzed accessibility for seven critical conditions based on spatial gaps, clinical need-gaps, lethality, coverage, and resource availability. Based on these metrics, unsupervised K-Means clustering was applied to categorize districts into four policy-actionable archetypes: Critical Structural Exclusion, Institutional Mirages, Operational Capacity Strain, and High-Resilience Benchmarks. Our study suggests that severe service deficits exist in the Northern and Eastern provinces, where spatial gaps exceed 70%, rendering the Golden Hour operationally impossible. Notably, specialist scarcity drives systemic pressure more than bed capacity; underserved regions effectively function as institutional mirages. This study suggests that improving accessibility by 25% in high-priority clusters would reduce the national need-gap by 9.65%, providing a roadmap for the strategic redistribution of specialists to ensure healthcare equity.