Access to trauma centers in the United States
Access to trauma centers in the United States
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DOI：
10.1001/jama.293.21.2626
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发表时间：
2005-06-01
影响因子：
120.7
通讯作者：
ReVelle, CS
中科院分区：
文献类型：
--
作者：
Branas, CC;MacKenzie, EJ;ReVelle, CS
背景 先前的研究报告称，各州创伤中心的数量和分布不均，这表明获得创伤中心护理的机会存在很大差异。目的估计在 45 和 60 分钟内进入创伤中心的美国居民的比例。使用来自 2 个国家数据库的数据设计和设置横断面研究，作为救护车和医院创伤资源分配模型 (TRAMAH) 项目的一部分。截至 2005 年 1 月，对所有 50 个州和哥伦比亚特区的创伤中心、基地直升机停机坪和街区群体人口进行了统计。 主要结果指标 在 45 和 60 分钟内通过地面救护车或直升机前往美国所有 703 个 I、II 和 III 级创伤中心的国家、地区和州人口的百分比。结果 估计占所有美国居民的 69.2% 和 84.1%有权访问 分别在 45 分钟和 60 分钟内到达 I 级或 11 级创伤中心。一小时内无法进入的 4670 万美国人主要生活在农村地区，而一小时内可以进入 20 个或更多一级或二级创伤中心的 4280 万美国人主要生活在城市地区。在 45 分钟和 60 分钟内，分别有 26.7% 和 27.7% 的美国居民只能通过直升机前往一级或二级创伤中心，1.9% 和 3.1% 的美国居民只能从本州以外的创伤中心或基地直升机停机坪前往一级或二级创伤中心。 结论 根据地理需要选择创伤中心，适当定位医疗直升机基地，并建立正式的共享协议 应考虑利用各州的创伤护理资源来改善美国获得创伤护理的机会。
Context Previous studies have reported that the number and distribution of trauma centers are uneven across states, suggesting large differences in access to trauma center care.Objective To estimate the proportion of US residents having access to trauma centers within 45 and 60 minutes.Design and Setting Cross-sectional study using data from 2 national databases as part of the Trauma Resource Allocation Model for Ambulances and Hospitals (TRAMAH) project. Trauma centers, base helipads, and block group population were counted for all 50 states and the District of Columbia as of January 2005.Main Outcome Measures Percentages of national, regional, and state populations having access to all 703 level I, II, and III trauma centers in the United States by either ground ambulance or helicopter within 45 and 60 minutes.Results An estimated 69.2% and 84.1% of all US residents had access to a level I or 11 trauma center within 45 and 60 minutes, respectively. The 46.7 million Americans who had no access within an hour lived mostly in rural areas, whereas the 42.8 million Americans who had access to 20 or more level I or II trauma centers within an hour lived mostly in urban areas. Within 45 and 60 minutes, respectively, 26.7% and 27.7% of US residents had access to level I or II trauma centers by helicopter only and 1.9% and 3.1% of US residents had access to level I or II centers only from trauma centers or base helipads outside their home states.Conclusion Selecting trauma centers based on geographic need, appropriately locating medical helicopter bases, and establishing formal agreements for sharing trauma care resources across states should be considered to improve access to trauma care in the United States.