Access to specialist care: Optimizing the geographic configuration of trauma systems

The Journal of Trauma and Acute Care Surgery
Jan O JansenMarion K Campbell

Abstract

The optimal geographic configuration of health care systems is key to maximizing accessibility while promoting the efficient use of resources. This article reports the use of a novel approach to inform the optimal configuration of a national trauma system. This is a prospective cohort study of all trauma patients, 15 years and older, attended to by the Scottish Ambulance Service, between July 1, 2013, and June 30, 2014. Patients underwent notional triage to one of three levels of care (major trauma center [MTC], trauma unit, or local emergency hospital). We used geographic information systems software to calculate access times, by road and air, from all incident locations to all candidate hospitals. We then modeled the performance of all mathematically possible network configurations and used multiobjective optimization to determine geospatially optimized configurations. A total of 80,391 casualties were included. A network with only high- or moderate-volume MTCs (admitting at least 650 or 400 severely injured patients per year, respectively) would be optimally configured with a single MTC. A network accepting lower-volume MTCs (at least 240 severely injured patients per year) would be optimally configured with two MTCs. Both c...Continue Reading

References

Mar 20, 2001·JAMA : the Journal of the American Medical Association·A B NathensF P Rivara
Jun 2, 2005·JAMA : the Journal of the American Medical Association·Charles C BranasCharles S ReVelle
Dec 21, 2005·Heart·K D DawkinsUNKNOWN Joint Working Group on Percutaneous Coronary Intervention of the British Cardiovascular Intervention Society and the British
Jan 27, 2006·The New England Journal of Medicine·Ellen J MacKenzieDaniel O Scharfstein
Mar 15, 2006·The Journal of Trauma·Garth H UtterAvery B Nathens
Sep 11, 2007·Emergency Medicine Clinics of North America·Vincent J Markovchick, Ernest E Moore
Jan 4, 2008·The Journal of Bone and Joint Surgery. American Volume·Ellen J MackenzieDaniel O Scharfstein
Sep 15, 2010·The Journal of Trauma·Syed Morad HameedUNKNOWN Research Committee of the Trauma Association of Canada
Nov 3, 2010·Journal of the American College of Surgeons·Barbara HaasAvery B Nathens
Nov 28, 2012·The British Journal of Surgery·J J MorrisonJ O Jansen
Mar 26, 2014·The Journal of Trauma and Acute Care Surgery·Jan O JansenMarion K Campbell
Mar 26, 2015·The Journal of Trauma and Acute Care Surgery·Barbara HaasAvery B Nathens
Apr 25, 2015·The Journal of Trauma and Acute Care Surgery·Jan O JansenDavid R Green

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Citations

Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Luke Regan, Charles Lee
Jan 24, 2017·Acta Anaesthesiologica Scandinavica·O UlebergP Klepstad
Jan 26, 2018·The Journal of Trauma and Acute Care Surgery·Jan O JansenAngela Sauaia
Dec 12, 2018·The Journal of Trauma and Acute Care Surgery·Jan O JansenThomas Cornulier
Feb 27, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Koen Van den HeedeMarie Isabel Farfan-Portet
Mar 14, 2019·The Journal of Trauma and Acute Care Surgery·Heather CarmichaelCatherine G Velopulos
Feb 20, 2018·Journal of the Intensive Care Society·Philip EmersonJan O Jansen
May 26, 2018·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Jo RøislienJ Theresia van Essen
Oct 6, 2020·The Journal of Trauma and Acute Care Surgery·Jan C Van DitshuizenDennis Den Hartog
Jun 22, 2016·Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention·Jo RøislienJ Theresia van Essen
Feb 21, 2021·BMC Medical Informatics and Decision Making·Acrapol NimmolratOrawit Thinnukool
Mar 24, 2021·Journal of Korean Medical Science·Jay Chol ChoiAnthony S Kim

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Software Mentioned

Geospatial Optimization of Systems of Trauma Care ( GEOS
Excel
MatLab
GEOS

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