A Geographic Information System to Evaluate Disparities in Access to Emergency Surgery Services

用于评估获得紧急手术服务差异的地理信息系统

基本信息

  • 批准号:
    9766399
  • 负责人:
  • 金额:
    $ 19.06万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2018
  • 资助国家:
    美国
  • 起止时间:
    2018-08-17 至 2021-03-31
  • 项目状态:
    已结题

项目摘要

PROJECT SUMMARY/ABSTRACT Emergency General Surgery (EGS) constitutes a significant public health burden in the United States. With approximately 3 million admissions a year, this subset of high-risk surgical conditions accounts for 50% of all surgical mortality, despite representing only 11% of surgical admissions. Timely access and presentation to facilities capable of rapid surgical intervention is critical for these conditions, as delays in care are associated with increased morbidity and mortality. Previous research in EGS has identified rural, minority, uninsured and socioeconomically disadvantaged populations as having higher rates of advanced clinical presentation and worse EGS outcomes, raising concerns for disparities in access to emergency surgical services. While it is intuitive that geographic access to care plays a role in EGS outcomes, it is unclear to what degree it interacts with the above socio-demographic factors and contributes to these disparities. The overarching goal of this proposal is to understand the etiology of disparities in access to EGS. Our central hypothesis is that geographic access contributes to EGS outcomes through interactions with social, patient and disease-related factors in a manner which disproportionately affects vulnerable populations. We will address these hypotheses through the following Specific Aims: (1) We will first develop a national geographic information system to quantify disparities in access to EGS services. Using national census and hospital data, we will generate an interactive map of EGS-capable hospitals, and layer this with distributions of key populations of interest: rural, minority, uninsured and low-income individuals. We will then use advanced spatial modelling techniques to quantify disparities in access to EGS hospitals for these populations and identify regions in greatest need of enhanced surgical capacity. (2) Subsequently, we will combine clinical data with spatial models to determine the contribution of geographic access to disparities in EGS outcomes. Using mixed-effects regression modelling, we will evaluate to what extent improving geographic access would reduce the observed outcome disparities for vulnerable populations. The proposed research represents a novel application of GIS technology to surgical research. The use of geospatial modelling will provide important insight into how geographic access and resource distribution contribute to surgical disparities for time-sensitive EGS conditions. This approach will further enable us to identify specific regions and populations to target for intervention. Finally, the development of a national GIS platform holds potential to inform future EGS regionalization and planning efforts by ensuring equitable distribution of services for vulnerable populations.
项目总结/文摘

项目成果

期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Use of the spatial access ratio to measure geospatial access to emergency general surgery services in California.
Disparities in Spatial Access to Emergency Surgical Services in the US.
  • DOI:
    10.1001/jamahealthforum.2022.3633
  • 发表时间:
    2022-10-07
  • 期刊:
  • 影响因子:
    0
  • 作者:
    McCrum, Marta L.;Wan, Neng;Han, Jiuying;Lizotte, Steven L.;Horns, Joshua J.
  • 通讯作者:
    Horns, Joshua J.
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Marta L. McCrum其他文献

Impact of premorbid oral anticoagulant use on survival in patients with traumatic intracranial hemorrhage.
病前口服抗凝药的使用对创伤性颅内出血患者生存的影响。
  • DOI:
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    4.1
  • 作者:
    David Botros;Diwas Gautam;Forrest A Hamrick;Sarah Nguyen;Janet Cortez;Jason B Young;Sarah Lombardo;Marta L. McCrum;S. Menacho;R. Grandhi
  • 通讯作者:
    R. Grandhi
Weight-based enoxaparin thromboprophylaxis in young trauma patients: analysis of the CLOTT-1 registry
年轻创伤患者基于体重的依诺肝素血栓预防:CLOTT-1 注册分析
  • DOI:
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    2
  • 作者:
    Sarah Lombardo;Marta L. McCrum;M. Knudson;Ernest E Moore;L. Kornblith;Scott Brakenridge;Brandon Bruns;M. Cipolle;Todd W. Costantini;Bruce Crookes;Elliott R. Haut;Andrew J. Kerwin;Laszlo N Kiraly;L. Knowlton;Matthew J. Martin;M. Mcnutt;David J. Milia;Alicia Mohr;Frederick Rogers;Thomas Scalea;S. Sixta;David Spain;Charles E Wade;G. Velmahos;Raminder Nirula;Jade M. Nunez
  • 通讯作者:
    Jade M. Nunez
Excess Mortality after Emergency General Surgery Readmission at Non-Index Hospitals: Patient and System Contributors
  • DOI:
    10.1016/j.jamcollsurg.2019.08.336
  • 发表时间:
    2019-10-01
  • 期刊:
  • 影响因子:
  • 作者:
    Austin R. Cannon;Matthew R. Kingsbury;Chelsea M. Allen;Angela P. Presson;Lyen C. Huang;Marta L. McCrum
  • 通讯作者:
    Marta L. McCrum
Impact of Insurance Expansion on Disposition for Pediatric Trauma Patients: A National Trauma Data Bank Cohort Study
  • DOI:
    10.1016/j.jss.2021.04.037
  • 发表时间:
    2021-11-01
  • 期刊:
  • 影响因子:
  • 作者:
    Liese C.C. Pruitt;Brian T. Bucher;Katie W. Russell;Marta L. McCrum
  • 通讯作者:
    Marta L. McCrum

Marta L. McCrum的其他文献

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