TY  - JOUR
PY  - 2019//
TI  - Location, location, location: utilizing NBATS-2 in trauma system planning
JO  - Journal of trauma and acute care surgery
A1  - Dooley, Jennings H.
A1  - Ozdenerol, Esra
A1  - Sharpe, John P.
A1  - Magnotti, Louis J.
A1  - Croce, Martin A.
A1  - Fischer, Peter E.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - INTRODUCTION: In 2015, the American College of Surgeons Committee on Trauma introduced the Needs-Based Assessment of Trauma Systems (NBATS) tool to quantify the optimal number of trauma centers for a region. While useful, more focus was required on injury population, distribution, and transportation systems. Therefore, NBATS-2 was developed utilizing advanced geographical modeling. The purpose of this study was to evaluate NBATS-2 in a large regional trauma system. <br><br>METHODS: Data from all injured patients from 2016-2017 with an ISS > 15 was collected from the trauma registry of the existing (legacy) center. Injury location and demographics were analyzed by zip code. A regional map was built using US census data to include hospital and population demographic data by zip code. Spatial modeling was conducted using ArcGIS to estimate an area within a 45-minute drive to a trauma center. <br><br>RESULTS: A total of 1,795 severely injured patients were identified across 54 counties in the tri-state region. 48% of the population and 58% of the injuries were within a 45-minute drive of the legacy trauma center. With the addition of another urban center, injured and total population coverage increased by only 1% while decreasing the volume to the existing center by 40%. However, the addition of two rural trauma centers increased coverage significantly to 62% of the population and 71% of the injured (p< 0.001). The volume of the legacy center was decreased by 25%, but the self-pay rate increased by 16%. <br><br>CONCLUSIONS: The geospatial modeling of NBATS-2 adds a new dimension to trauma system planning. This study demonstrates how geospatial modeling applied in a practical tool can be incorporated into trauma system planning at the local level and used to assess changes in population and injury coverage within a region, as well as potential volume and financial implications to a current system. LEVEL OF EVIDENCE: Level V STUDY TYPE: Observational.<p />  <p>Language: en</p>
LA  - en
SN  - 2163-0755
UR  - http://dx.doi.org/10.1097/TA.0000000000002463
ID  - ref1
ER  -