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Gender-associated differences in access to trauma center care: A population-based analysis
David Gomez1, Barbara Haas, Charles de Mestral
1Division of General Surgery, Department of Surgery, University of Toronto, Ontario, Canada.david.gomezjaramillo@utoronto.ca
Surgery
|June 26, 2012
Summary
Severely injured women are less likely to receive trauma center care compared to men. This disparity persists across emergency medical services and physician referrals, suggesting potential biases in access to critical surgical care.
Area of Science:
- Trauma surgery
- Healthcare disparities
- Emergency medicine
Background:
- Gender disparities in healthcare access are documented.
- The impact of gender on emergency surgical care access remains unclear.
- Trauma triage guidelines aim for objective patient care allocation.
Purpose of the Study:
- To evaluate if gender influences access to trauma center care for severely injured adults.
- To identify gender-based differences in direct transport and inter-facility transfers to trauma centers.
Main Methods:
- Retrospective cohort analysis of severely injured adults (Injury Severity Score >15).
- Comparison of trauma center care access between females and males.
- Logistic regression models adjusted for confounders (age, mechanism, injury severity).
Main Results:
- 35% of 26,861 severely injured patients were women.
- Females had lower trauma center care rates (49%) vs. males (62%).
- Adjusted analysis showed females had lower odds of trauma center access (OR, 0.87; 95% CI, 0.79-0.96).
- Both EMS and physicians were less likely to direct females to trauma centers.
Conclusions:
- Severely injured women experience reduced access to trauma centers.
- This disparity exists across emergency medical services and physician-led transfers.
- Potential contributing factors include perceived injury severity, benefit likelihood, or subconscious gender bias.
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