Optimizing Trauma Systems: A Geospatial Analysis of the Victorian State Trauma System

Area of Science:

• Emergency Medicine
• Health Services Research
• Operations Research

Background:

• Regionalized trauma systems demonstrably reduce mortality and enhance patient outcomes.
• Increasing major trauma case volumes necessitate the evolution of trauma system configurations.
• Optimizing trauma system design is crucial for managing escalating patient numbers.

Purpose of the Study:

• To develop a data-driven methodology for assessing trauma system parameters.
• To optimize the configuration of the Victorian State Trauma System (VSTS).
• To model the impact of potential system changes on optimal trauma care delivery.

Main Methods:

• Retrospective analysis of 8327 major trauma patients (2016-2018) in Victoria, Australia.
• Calculation of drive and flight times to 138 trauma receiving hospitals.
• Application of Mixed Integer Linear Programming across 156 simulations to model VSTS configuration changes.

Main Results:

• 58% of patients were directly transported to a Major Trauma Service (MTS).
• Direct MTS transport for adults correlated with higher transport time limits, increased helicopter utilization, and lower hospital thresholds.
• Simulations showed adult direct MTS transport ranging from 66% to 90%; pediatric patients consistently had only one assigned MTS.

Conclusions:

• A robust, data-driven approach for trauma system optimization has been established.
• Geospatial and mathematical modeling effectively simulates future trauma system configurations.
• Findings empower policymakers with informed decision-making for future health service planning.