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/摘要 在美国,急诊普通外科(EGS)是一个重大的公共卫生负担。与 每年约有300万例入院,这部分高危手术病例占所有病例的50%。 手术死亡率,尽管仅占手术入院的11%。及时获取和提交 能够快速手术干预的设施对这些疾病至关重要,因为护理延迟与 发病率和死亡率增加。以前的EGS研究已经确定了农村,少数民族,无保险和 社会经济弱势人群的晚期临床表现率较高, EGS结果更差,引起了人们对获得紧急手术服务的不平等的关注。虽然 直觉上,地理上获得护理的机会在EGS结果中起作用,但尚不清楚它在多大程度上相互作用 上述社会人口因素的影响,并促成了这些差距。 该提案的总体目标是了解环境商品和服务获取方面的差距的根源。我们的中央 假设是地理通道通过与社会、患者和 与疾病有关的因素对脆弱人口的影响尤为严重。我们将解决 这些假设通过以下具体目标:(1)我们将首先制定一个国家地理 信息系统,以量化在获得环境商品和服务方面的差距。利用全国人口普查和医院数据, 我们将生成一个交互式地图的电子政务能力的医院,并分层与分布的关键 感兴趣的人群:农村、少数民族、无保险和低收入个人。然后我们将使用高级 空间建模技术,以量化这些人群在获得EGS医院方面的差异, 确定最需要加强外科能力的地区。(2)随后,我们将联合收割机的临床数据 空间模型,以确定在EGS结果的差异的地理访问的贡献。使用 混合效应回归模型,我们将评估在多大程度上改善地理通道将减少 观察到的弱势群体的结果差异。 该研究代表了GIS技术在外科研究中的新应用。使用 地理空间建模将提供重要的洞察力,以了解地理通道和资源分布 导致对时间敏感的EGS条件的手术差异。这种方法将进一步使我们能够 确定干预的具体区域和人群。最后,开发国家地理信息系统 该平台有可能通过确保公平、公正的环境和商品服务,为未来的环境和商品服务区域化和规划工作提供信息 为弱势群体提供服务。

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)
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.
Use of the spatial access ratio to measure geospatial access to emergency general surgery services in California.
{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

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

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

相似海外基金

Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
  • 批准号:
    MR/S03398X/2
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Fellowship
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
  • 批准号:
    EP/Y001486/1
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Research Grant
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
  • 批准号:
    2338423
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Continuing Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
  • 批准号:
    MR/X03657X/1
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
  • 批准号:
    2348066
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
  • 批准号:
    AH/Z505481/1
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10107647
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    EU-Funded
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
  • 批准号:
    2341402
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Standard Grant
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10106221
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
  • 批准号:
    AH/Z505341/1
  • 财政年份:
    2024
  • 资助金额:
    $ 19.06万
  • 项目类别:
    Research Grant
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了