导航中风护理:区域中风中心可访问性的地理空间评估:中风中心的地理空间评估
Stephen Halada1, Kirsten Mm Beyer2, Yuhong Zhou2
1Medical Student, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
概括
威斯康星州小城镇的居民面临长时间前往高级中风中心 (ASC) 的旅行时间,并经历高中风死亡率. 这份地理分析强调了关键的中风护理接入差距,特别是在农村地区,为更好的紧急医疗服务分配资源提供了信息.
科学领域:
- 地理信息系统 (GIS) 和公共卫生中的空间分析.
- 卫生服务研究和可访问性研究.
- 脑卒中流行病学和紧急医疗服务 (EMS).
背景情况:
- 在中风后的及时医院干预对患者的治疗结果至关重要.
- 使用EMS可以改善获得中风护理的机会,但地理障碍仍然存在.
- 美国许多地区缺乏接近能够提供先进护理的中风中心 (ASC).
研究的目的:
- 确定威斯康星州的高中风死亡率和有限的物理可访问性ASC的地区.
- 分析中风死亡率和ASCs的地理分布.
- 为了告知紧急医疗资源的战略分配.
主要方法:
- 利用来自威斯康星州卫生服务部的地理编码中风死亡记录 (2015-2020年).
- 在整个威斯康星州使用自适应空间选和人口普查区组级别的死亡记录进行持续估计,按人口普查区平均.
- 收集了SC位置,估计了前往最近ASC亚型的行车时间,并使用空间错误回归建模与农村-城市通勤区 (RUCA) 代码一起评估.
主要成果:
- 50%,68%和78%的居民分别在距离ASC30分钟,45分钟和60分钟之内.
- 农村 (90分钟) 和小城镇 (82分钟) 地区到达ASC的平均行车时间明显高于大都市 (19分钟) 地区.
- 在城市和农村集群中观察到高冲击的SMR,小城区的区域无论ASC可访问性如何都显示出最高的SMR.
结论:
- 小城区面临的双重挑战是长途驾驶到ASC的距离,以及中风死亡率的增加.
- 地理分析揭示了威斯康星州重要的"中风护理沙漠".
- 这些发现可以指导紧急医疗资源的战略分配,以改善中风护理的准入.
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