A Process to Calculate Travel Time to a Trauma Center and Assess Trauma Center Coverage in Virginia

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2017-08-08
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Abstract

Travel time is a major hurdle to the utilization of all kinds of health services. Although health outcomes are dependent on factors including injury severity, patients who do not receive care in a timely fashion are at increased risk of death. Longer travel times to hospitals can lead to negative patient outcomes, especially for patients with time sensitive conditions like trauma.

Trauma is always unexpected. It is one of the foremost causes of mortality in the United States for people aged 45 and below and also the fourth leading cause of mortality for all ages [1]. Access to trauma care is not uniform in the United States and as such many trauma victims do not get the required medical attention in time. Critically injured patients require timely Emergency Medical Service (EMS) transport to the nearest trauma center as the following minutes are critical with regard to saving the victim’s life and minimizing the effects of injuries. If trauma patients do not arrive at a trauma center within an hour on injury, it leads to suboptimal health outcomes [2]. The reason often cited for delayed transportation of trauma patients is the travel time to the nearest trauma center which is further compounded by adverse traffic conditions, if ground EMS transport is used.

Motor vehicle crash records do not include transport times between crash location and trauma care centers. EMS records are not easily available but they contain information on transport time from the crash location. There is no unique identifier to link the Crash records to EMS records. In this case, a method that can estimate transport time from the crash location to the nearest trauma care facility could provide valuable information to assess the coverage of trauma care centers for victims in motor vehicle crashes.

The goal of this project was to assess the coverage of trauma care centers in Virginia by developing and validating a method that can estimate the transport time between crash location and the nearest trauma center. This is evaluated using statistical analysis; Pearson’s correlation, ttest and ANOVA test to determine if it provides a reasonable representation of the actual EMS reported transport times. This will help draw inferences using both crash records and EMS records which can help improve crash related safety.

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Keywords
Car crashes, EMS response time, Trauma Center, Crash severity, Service areas, EMS transport time
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