@article{4ed0f6d9be3c43deb44c8af884a641d0,
title = "Access to trauma center care: A statewide system-based approach",
abstract = "BACKGROUND Timely access to specialized trauma care is a vital element in patient outcome after severe and critical injury requiring the skills of trauma teams in levels I and II trauma centers to avoid preventable mortality. We used system-based models to estimate timely access to care. METHODS Trauma system models consisted of ground emergency medical services, helicopter emergency medical services, and designated levels I to V trauma centers were constructed for five states. These models incorporated geographic information systems along with traffic data and census block group data to estimate population access to trauma care within the {"}golden hour.{"}Trauma systems were further analyzed to identify the optimal location for an additional level I or II trauma center that would provide the greatest increase in access. RESULTS The population of the states studied totaled 23 million people, of which 20 million (87%) had access to a level I or II trauma center within 60 minutes. Statewide-specific access ranged from 60% to 100%. Including levels III to V trauma centers, access within 60 minutes increased to 22 million (96%), ranging from 95% to 100%. The addition of a levels I and II trauma center in an optimized location in each state would provide timely access to a higher trauma capability for an additional 1.1 million, increasing total access to approximately 21.1 million people (92%). CONCLUSION This analysis demonstrates that nearly universal access to trauma care is present in these states when including levels I to V trauma centers. However, concerning gaps remain in timely access to levels I and II trauma centers. This study provides an approach to determine more robust statewide estimates of access to care. It highlights the need for a national trauma system, one in which all components of state-managed trauma systems are assembled in a national data set to accurately identify gaps in care. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV.",
keywords = "Prehospital, access to care, trauma, trauma system",
author = "{MIMIC Study Group} and Medrano, {Nicolas W.} and Villarreal, {Cynthia Lizette} and Price, {Michelle A.} and Bixby, {Pamela J.} and Bulger, {Eileen M.} and Eastridge, {Brian J.} and Albrecht, {Roxie M.} and Bailey, {Jeffrey A.} and Benjamin, {Elizabeth R.} and Bernard, {Andrew C.} and Blackwell, {Thomas H.} and Braithwaite, {Sabina A.} and Brasel, {Karen J.} and Brice, {Jane H.} and Burlew, {Clay C.} and Butler, {Frank K.} and Callaway, {David W.} and Cannon, {Jeremy W.} and Champion, {Howard R.} and Michael Chang and Coimbra, {Raul S.} and Davis, {Gregory G.} and Demarest, {Gerald B.} and Dorlac, {Warren C.} and Drake, {Stacy A.} and Eastman, {Alex L.} and Elster, {Eric A.} and Eric Epley and Esposito, {Thomas J.} and Ficke, {James R.} and Fisher, {Andrew D.} and Fowler, {David R.} and Gaines, {Barbara A.} and Gallagher, {John M.} and Gary, {Joshua L.} and Gestring, {Mark L.} and Gill, {James R.} and Goodloe, {Jeffrey M.} and Gurney, {Jennifer M.} and Harrell, {Andrew J.} and Henry, {Sharon M.} and Holcomb, {John B.} and Jenkins, {Donald H.} and Johannigman, {Jay A.} and Kerby, {Jeffrey D.} and Kharod, {Chetan U.} and Kotwal, {Russ S.} and Kozar, {Rosemary A.} and Kuhls, {Deborah A.} and Lathrop, {Sarah L.}",
note = "Funding Information: This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Defense Medical Research and Development Program under award number W81XWH-17-2-0010. The views, opinions, and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy, or decision unless so designated by other documentation. In the conduct of research where humans are the subjects, the investigator(s) adhered to the policies regarding the protection of human subjects as prescribed by Code of Federal Regulations Title 45, Volume 1, Part 46; Title 32, Chapter 1, Part 219; and Title 21, Chapter 1, Part 50 (Protection of Human Subjects). DISCLOSURE Publisher Copyright: {\textcopyright} Wolters Kluwer Health, Inc. All rights reserved.",
year = "2023",
month = aug,
day = "1",
doi = "10.1097/TA.0000000000004002",
language = "English",
volume = "95",
pages = "242--248",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "LWW",
number = "2",
}