Geographic disparities in access to urban trauma care: defining the problem and identifying a solution for gunshot wound victims in Chicago

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• 作者：Michael Wandling ; M.D.^a ; Jess Behrens ; M.S.^a ; ¹ ; Renee Hsia ; M.D. ; M.Sc.^b ; Marie Crandall ; M.D. ; M.P.H.^a ; ² ; ^{marie.crandall@jax.ufl.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Trauma systems ; Access ; Disparities ; Prehospital transport
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：212
• 期：4
• 页码：587-591
• 全文大小：474 K

文摘

Timely transport to designated trauma centers impacts mortality following serious injury. We examined whether the distribution of trauma centers in Chicago has created disparities in access to trauma care.

Methods

Using the Illinois State Trauma Registry, locations of Chicago-area gunshot wounds (GSWs) from 1999 to 2009 were geocoded and transport times were analyzed for pediatric (age ≤ 15) and adult (age ≥ 16) GSWs.

Results

A total of 11,744 included pediatric and adult GSWs were analyzed. Adults experienced longer mean transport times (11.3 vs 10.2 minutes, P < .001). Disproportionate numbers of adult GSW victims experienced over 30-minute transport times on Chicago's south side. Pediatric GSWs demonstrated no such disparity, likely attributable to the presence of a pediatric trauma center on the southeast side.

Conclusions

Geographic disparities in access to trauma care exist even within urban trauma systems. The absence of an adult trauma center on Chicago's southeast side has contributed to these disparities.