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Defining geographic emergency medical services coverage in trauma systems
Joshua B Brown1, Matthew R Rosengart, Andrew B Peitzman
1From the Division of Trauma and General Surgery, Department of Surgery (J.B.B., M.R.R., A.B.P., T.R.B., J.L.S.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
The Journal of Trauma and Acute Care Surgery
|July 2, 2019
Summary
Ground emergency medical services (EMS) coverage impacts trauma outcomes. A new index (GEMSI) quantifies EMS distribution, correlating with reduced fatality rates and aiding resource optimization.
Area of Science:
- Emergency Medicine
- Public Health
- Spatial Analysis
Background:
- Trauma system resource distribution, including trauma centers and helicopter bases, is linked to patient outcomes.
- Quantifying ground emergency medical services (EMS) coverage presents challenges due to its dynamic nature.
- Understanding ground EMS coverage is crucial for optimizing trauma system effectiveness.
Purpose of the Study:
- To evaluate measures describing ground EMS coverage within trauma systems.
- To correlate these measures with transportation injury fatality rates.
- To develop a tool for assessing and comparing ground EMS coverage.
Main Methods:
- An ecological study in Pennsylvania mapped trauma system resources.
- Measures of county EMS coverage included distance to trauma centers, unit density, and geographic patterns.
- Spatial-lag regression analyzed associations between fatality rates and EMS coverage measures, developing a Geographic Emergency Medical Services Index (GEMSI).
Main Results:
- Lower fatality rates were associated with shorter distances to trauma centers, higher advanced life support unit density, and dispersed EMS agency patterns.
- The GEMSI explained 49% of the variation in county transportation injury fatality rates.
- Optimizing EMS agency distribution and helicopter base placement showed significant potential to reduce fatality rates.
Conclusions:
- The developed Geographic Emergency Medical Services Index (GEMSI) effectively correlates with trauma patient outcomes.
- GEMSI can be utilized to describe and compare ground EMS coverage across different geographic areas.
- This tool can guide the optimization of trauma system resource allocation for improved public health outcomes.
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