米国内のトラウマセンターへのアクセス
Charles C Branas1, Ellen J MacKenzie, Justin C Williams
1Center for Clinical Epidemiology and Biostatistics, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Medicine, Philadelphia 19104-6021, USA. cbranas@cceb.med.upenn.edu
JAMA
|June 2, 2005
まとめ
何百万ものアメリカ人は,特に農村部では,トラウマセンターに間に合うアクセスを欠いています. トラウマケアへのアクセスを改善するには,トラウマセンターとヘリパッドの戦略的配置,州間資源共有が必要です.
科学分野:
- 緊急医療 緊急医療
- 公衆衛生は公衆衛生である.
- 医療サービス 研究 医療サービス
背景:
- トラウマセンターの分布はアメリカ各州で不均一で,重症治療へのアクセスに格差が生じています.
- 以前の研究は,トラウマセンターの利用可能性における州レベルの大きな違いを示しています.
研究 の 目的:
- 45分から60分以内にトラウマセンターにアクセスできる米国の人口の割合を定量化するために.
- トラウマセンターのアクセシビリティにおける地理的な格差を特定する.
主な方法:
- トラウマ・リソース・アロケーション・モデル・フォー・アンブランス・アンド・ホスピタル (TRAMAH) プロジェクトからの国家データベースを利用した横断的な研究が行われました.
- データには,2005年1月の時点で50州とDCのすべてのトラウマセンター,ヘリパッド,人口統計が含まれていました.
- 地上輸送や空中輸送で,特定時間枠内で,レベルI,II,IIIのトラウマセンターへの住民のアクセスを計算する.
主要な成果:
- 推定69.2%と84.1%の米国住民は,それぞれ45分と60分以内にレベルIまたはIIトラウマセンターにアクセスできた.
- 1時間以内に4670万人のアメリカ人が,主に農村部で,アクセスできなくなった.
- ヘリコプターによるアクセスのみが制限され,それぞれ45分と60分以内にアクセスできる割合は26.7%と27.7%でした.
結論:
- 地理的なニーズ評価は,トラウマセンターの選択とリソースの配分に不可欠です.
- 医療ヘリコプター基地とトラウマケア共有のための州間協定の戦略的配置が推奨されています.
- これらの戦略は,全国的なトラウマケアアクセシビリティを強化し,現在の格差に対処することを目的としています.
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