访问美国的创伤中心
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
概括
数以百万计的美国人无法及时进入创伤中心,特别是在农村地区. 改善创伤护理的准入需要创伤中心和直升机停机场的战略布局,以及州际资源共享.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 创伤中心在美国各州的分布不均,导致进入重症监护的差异.
- 以前的研究表明,创伤中心可用性的州级差异很大.
研究的目的:
- 量化美国人口在45到60分钟内进入创伤中心的比例.
- 为了确定创伤中心可访问性的地理差异.
主要方法:
- 一项横截面研究利用了来自救护车和医院创伤资源分配模型 (TRAMAH) 项目的国家数据库.
- 截至2005年1月,数据包括所有50个州和华盛顿特区的创伤中心,直升机停机场和人口统计数据.
- 计算人口通过地面或空中运输在特定时间范围内进入一级,二级和三级创伤中心.
主要成果:
- 据估计,69.2%和84.1%的美国居民可以在45分钟和60分钟内进入一级或二级创伤中心.
- 46.7百万美国人在一个小时内无法访问,主要是在农村地区.
- 只有直升机的访问是有限的,其中26.7%和27.7%的访问时间分别为45分钟和60分钟.
结论:
- 地理需求评估对于创伤中心的选择和资源分配至关重要.
- 建议对医疗直升机基地的战略布局和创伤护理共享的州际协议进行建议.
- 这些战略旨在在全国范围内提高创伤护理的可访问性,解决目前的差距.
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