@article{ref1,
title="Geographic disparities in re-triage destinations among seriously injured Californians",
journal="Annals of surgery open",
year="2023",
author="Furmanchuk, Al'ona and Rydland, Kelsey James and Hsia, Renee Y. and Mackersie, Robert and Shi, Meilynn and Hauser, Mark William and Kho, Abel and Bilimoria, Karl Y. and Stey, Anne M.",
volume="4",
number="1",
pages="e270-e270",
abstract="OBJECTIVE: To quantify geographic disparities in sub-optimal re-triage of seriously injured patients in California.   SUMMARY OF BACKGROUND DATA: Re-triage is the emergent transfer of seriously injured patients from the emergency departments of non-trauma and low-level trauma centers to, ideally, high-level trauma centers. Some patients are re-triaged to a second non-trauma or low-level trauma center (sub-optimal) instead of a high-level trauma center (optimal). <br><br>METHODS: This was a retrospective observational cohort study of seriously injured patients, defined by an Injury Severity Score > 15, re-triaged in California (2009-2018). Re-triages within one day of presentation to the sending center were considered. The sub-optimal re-triage rate was quantified at the state, regional trauma coordinating committees (RTCC), local emergency medical service agencies, and sending center level. A generalized linear mixed-effects regression quantified the association of sub-optimality with the RTCC of the sending center. Geospatial analyses demonstrated geographic variations in sub-optimal re-triage rates and calculated alternative re-triage destinations. <br><br>RESULTS: There were 8,882 re-triages of seriously injured patients and 2,680 (30.2 %) were sub-optimal. Sub-optimally re-triaged patients had 1.5 higher odds of transfer to a third short-term acute care hospital and 1.25 increased odds of re-admission within 60 days from discharge. The sub-optimal re-triage rates increased from 29.3 % in 2009 to 38.6 % in 2018. 56.0 % of non-trauma and low-level trauma centers had at least one sub-optimal re-triage. The Southwest RTCC accounted for the largest proportion (39.8 %) of all sub-optimal re-triages in California. <br><br>CONCLUSION: High population density geographic areas experienced higher sub-optimal re-triage rates.<p /> <p>Language: en</p>",
language="en",
issn="2691-3593",
doi="10.1097/as9.0000000000000270",
url="http://dx.doi.org/10.1097/as9.0000000000000270"
}