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Emergency Undocking in Robotic Surgery: A Simulation Curriculum
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Published on: May 20, 2018

Simulating changes to emergency care resources to compare system effectiveness.

Charles C Branas1, Catherine S Wolff, Justin Williams

  • 1Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, 423 Guardian Drive, Philadelphia, PA 19104, USA. cbranas@upenn.edu

Journal of Clinical Epidemiology
|July 16, 2013
PubMed
Summary
This summary is machine-generated.

Optimizing trauma center (TC) and helicopter depot (HD) locations significantly improves emergency care access. Strategic placement of TCs offers greater access gains than HDs, highlighting the power of systems optimization.

Keywords:
Access to careGeographyHealth policyHealth system optimizationLocation scienceTrauma centerWound and injuries

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Published on: January 15, 2017

Area of Science:

  • Emergency medicine
  • Operations research
  • Health systems science

Background:

  • Access to timely emergency care is crucial for severely injured patients.
  • Existing trauma center (TC) and helicopter depot (HD) locations may not be optimal for maximizing patient access.
  • Systems optimization offers a quantitative approach to evaluate resource allocation.

Purpose of the Study:

  • To apply systems optimization methods to identify the most effective locations for emergency care resources.
  • To compare the impact of optimizing trauma center and helicopter depot locations on patient access to care.

Main Methods:

  • An optimization analysis was conducted on the locations of trauma centers (TCs), helicopter depots (HDs), and patient data in select US states.
  • Access was defined as the percentage of injured patients reaching a Level I/II TC within 45 or 60 minutes.
  • A search algorithm identified optimal resource locations by maximizing patient access.

Main Results:

  • Existing access to TCs within 60 minutes varied widely (31.1%–95.6%, mean 71.5%).
  • Optimally adding one or two TCs increased access by 0.8%–35.0%.
  • Optimally adding one or two HDs increased access by 1.0%–15.3%; relocating resources yielded similar improvements.

Conclusions:

  • Optimal trauma center adjustments yielded greater access improvements than helicopter depot adjustments.
  • Systems optimization effectively compares resource configurations and their impact on access to care.
  • These methods are applicable to comparative effectiveness and patient-centered outcomes research.