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Abstract
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BACKGROUND: Timely access to specialized trauma care is a vital element in patient outcome after severe and critical injury requiring the skills of trauma teams in level I and II trauma centers to avoid preventable mortality. We utilized system-based models to estimate timely access to care.
METHODS: Trauma system models comprised of ground EMS (GEMS), helicopter EMS (HEMS), and designated level I - V trauma centers were constructed for five states. These models incorporated geographic information systems (GIS) along with traffic data and census block group data to estimate population access to trauma care within the "golden hour." Trauma systems were further analyzed to identify the optimal location for an additional level I or II trauma center that would provide the greatest increase in access.
RESULTS: The population of the states studied totaled 23 million people, of which 20 million (87%) had access to a level I or II trauma center within 60 minutes. Statewide specific access ranged from 60% to 100%. Including level III - V trauma centers, access within 60 minutes increased to 22 million (96%), ranging from 95% to 100%. The addition of a level I-II trauma center in an optimized location in each state would provide timely access to a higher trauma capability for an additional 1.1 million, increasing total access to approximately 21.1 million people (92%).
CONCLUSIONS: This analysis demonstrates that nearly universal access to trauma care is present in these states when including level I-V trauma centers. However, concerning gaps remain in timely access to level I-II trauma centers. This study provides an approach to determine more robust statewide estimates of access to care. It highlights the need for a national trauma system, one in which all components of state-managed trauma systems are assembled in a national dataset to accurately identify gaps in care.Level of Evidence: Original Research, IV.
Language: en |