TY  - JOUR
PY  - 2019//
TI  - Distance to trauma centres among gunshot wound victims: identifying trauma 'deserts' and 'oases' in Detroit
JO  - Injury prevention
A1  - Circo, Giovanni M.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - INTRODUCTION: Among the factors related to survival among individuals with gun shot wounds (GSW) is distance to trauma care. Relatively little is known about neighbourhood-level patterns of GSW mortality and distance to hospitals with trauma centres. This study focuses on distance to the nearest trauma centre as a correlate of survival among GSW victims. <br><br>METHODS: Fatal and non-fatal shooting incident data for 9,205 victimisation in Detroit, Michigan between 2011 and 2017 were collected. A Bayesian conditional autoregressive model was utilised to estimate block-group levels of GSW mortality. Clustering techniques were used to identify spatially proximate neighbourhoods with higher or lower than expected rates of GSW mortality. <br><br>RESULTS: Distance to the nearest trauma centre was associated with a 22% increase in fatal outcomes, per-mile (OR 1.22, 95% CI, 1.06 to 1.40) after adjusting for block-group level covariates. A Getis-Ord G<sub>i</sub>* analysis identified 91 block groups with lower than expected rates of GSW mortality and 12 block-groups with higher than expected rates. <br><br>CONCLUSION: Distance to the nearest trauma centre is associated with GSW victim survival. Clusters of block-groups with below-average GSW mortality were observed within close proximity of major trauma centres in Detroit. Improving speed and access to trauma care may play a role in reducing GSW mortality.<br><br>© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.<p />  <p>Language: en</p>
LA  - en
SN  - 1353-8047
UR  - http://dx.doi.org/10.1136/injuryprev-2019-043180
ID  - ref1
ER  -