Injury-based Geographic Access to Trauma Centers

Area of Science:

• Emergency Medicine
• Health Services Research
• Geographic Information Systems

Background:

• Previous trauma care access studies used patient residence, potentially misrepresenting service availability.
• Understanding geographic access based on incident location is crucial for accurate needs assessment.

Purpose of the Study:

• To evaluate U.S. geographic access to trauma centers using trauma incident locations.
• To analyze trauma center capacity-to-demand and accessibility ratios.

Main Methods:

• Cross-sectional study using 2014 National Emergency Medical Services Information System data and American Hospital Association data.
• Analysis of 9-1-1 activations for traumatic injury and trauma center locations.
• Calculated 60-minute ground ambulance transport feasibility, capacity-to-demand ratios, and zip code accessibility ratios.

Main Results:

• 92.9% of trauma incidents were within 60 minutes of a trauma center; 85.3% to Level I/II centers.
• Northeast had high transport feasibility (94.7%) but low capacity-to-demand ratios.
• Midwestern and Southern states showed better accessibility relative to injury numbers than Northeastern states.

Conclusions:

• Trauma care access varies significantly by U.S. region when assessed by incident location.
• Incident location provides a more accurate measure of trauma care access than patient residence.
• Developed capacity-to-demand and accessibility ratios are applicable to broader healthcare needs assessments.