TY - JOUR PY - 2017// TI - Development of a model to quantify the accessibility of a Canadian trauma system JO - Canadian journal of emergency medicine A1 - Tansley, Gavin A1 - Schuurman, Nadine A1 - Erdogan, Mete A1 - Bowes, Matthew J. A1 - Green, Robert A1 - Asbridge, Mark A1 - Yanchar, Natalie SP - 285 EP - 292 VL - 19 IS - 4 N2 - OBJECTIVES: Trauma systems have been widely implemented across Canada, but access to trauma care remains a challenge for much of the population. This study aims to develop and validate a model to quantify the accessibility of definitive care within one provincial trauma system and identify populations with poor access to trauma care.

METHODS: A geographic information system (GIS) was used to generate models of pre-scene and post-scene intervals, respectively. Models were validated using a population-based trauma registry containing data on prehospital time intervals and injury locations for Nova Scotia (NS). Validated models were then applied to describe the population-level accessibility of trauma care for the NS population as well as a cohort of patients injured in motor vehicle collisions (MVCs).

RESULTS: Predicted post-scene intervals were found to be highly correlated with documented post-scene intervals (β 1.05, p<0.001). Using the model, it was found that 88.1% and 42.7% of the population had access to Level III and Level I trauma care within 60 minutes of prehospital time from their residence, respectively. Access for victims of MVCs was lower, with 84.3% and 29.7% of the cohort having access to Level III and Level I trauma care within 60 minutes of the location of injury, respectively.

CONCLUSION: GIS models can be used to identify populations with poor access to care and inform service planning in Canada. Although only 43% of the provincial population has access to Level I care within 60 minutes, the majority of the population of NS has access to Level III trauma care.

Language: en

LA - en SN - 1481-8035 UR - http://dx.doi.org/10.1017/cem.2017.9 ID - ref1 ER -