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CJEM. 2017 Jul;19(4):285-292. doi: 10.1017/cem.2017.9. Epub 2017 Mar 27.

Development of a model to quantify the accessibility of a Canadian trauma system.

Author information

1
*Department of Surgery,Dalhousie University,Halifax,NS.
2
†Department of Geography,Simon Fraser University,Burnaby,BC.
3
‡Trauma Nova Scotia,Halifax,NS.
4
§Nova Scotia Medical Examiner Service,Dartmouth,NS.
5
¶Department of Critical Care Medicine,Dalhousie University,Halifax,NS.
6
††Department of Community Health and Epidemiology,Dalhousie University,Halifax,NS.

Abstract

OBJECTIVES:

Trauma systems have been widely implemented across Canada, but access to trauma care remains a challenge for much of the population. This study aims to develop and validate a model to quantify the accessibility of definitive care within one provincial trauma system and identify populations with poor access to trauma care.

METHODS:

A geographic information system (GIS) was used to generate models of pre-scene and post-scene intervals, respectively. Models were validated using a population-based trauma registry containing data on prehospital time intervals and injury locations for Nova Scotia (NS). Validated models were then applied to describe the population-level accessibility of trauma care for the NS population as well as a cohort of patients injured in motor vehicle collisions (MVCs).

RESULTS:

Predicted post-scene intervals were found to be highly correlated with documented post-scene intervals (β 1.05, p<0.001). Using the model, it was found that 88.1% and 42.7% of the population had access to Level III and Level I trauma care within 60 minutes of prehospital time from their residence, respectively. Access for victims of MVCs was lower, with 84.3% and 29.7% of the cohort having access to Level III and Level I trauma care within 60 minutes of the location of injury, respectively.

CONCLUSION:

GIS models can be used to identify populations with poor access to care and inform service planning in Canada. Although only 43% of the provincial population has access to Level I care within 60 minutes, the majority of the population of NS has access to Level III trauma care.

KEYWORDS:

GIS; Geographic Information Systems; access; trauma

PMID:
28343457
DOI:
10.1017/cem.2017.9
[Indexed for MEDLINE]

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