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Geographic disparities in access to urban trauma care: defining the problem and identifying a solution for gunshot
Michael Wandling1, Jess Behrens1, Renee Hsia2
1Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 650, Chicago, IL 60611, USA.
Background:
Timely transport to designated trauma centers impacts mortality following serious injury. We examined whether the distribution of trauma centers in Chicago has created disparities in access to trauma care.
Methods:
Using the Illinois State Trauma Registry, locations of Chicago-area gunshot wounds (GSWs) from 1999 to 2009 were geocoded and transport times were analyzed for pediatric (age ≤ 15) and adult (age ≥ 16) GSWs.
Results:
A total of 11,744 included pediatric and adult GSWs were analyzed. Adults experienced longer mean transport times (11.3 vs 10.2 minutes, P < .001). Disproportionate numbers of adult GSW victims experienced over 30-minute transport times on Chicago's south side. Pediatric GSWs demonstrated no such disparity, likely attributable to the presence of a pediatric trauma center on the southeast side.
Conclusions:
Geographic disparities in access to trauma care exist even within urban trauma systems. The absence of an adult trauma center on Chicago's southeast side has contributed to these disparities.
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