Adult and elderly population access to trauma centers: an ecological analysis evaluating the relationship between injury-related mortality and geographic proximity in the United States in 2010

Adult and elderly population access to trauma centers an ecological analysis evaluating the relationship between injury-related mortality and geographic proximity in the United States in 2010

Ongoing development and expansion of trauma centers in the United States necessitates empirical analysis of the effect of investment in such resources on population-level health outcomes. Multiple linear regressions were performed to predict state-level trauma-related mortality among adults and the...

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Bibliographic Details
Published in:Journal of public health (Oxford, England) Vol. 40; no. 4; pp. 848 - 857
Main Authors: Dodson, B.K., Braswell, M., David, A.P., Young, J.S., Riccio, L.M., Kim, Y., Calland, J.F.
Format: Journal Article
Language:English
Published: England Oxford University Press 01-12-2018
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Humans
Interventions (services)
Linear Models
Middle Aged
Original
Retrospective Studies
Spatial Analysis
Trauma Centers - supply & distribution
Treatment Outcome
United States - epidemiology
Wounds and Injuries - mortality
Young Adult
United States
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Summary:Ongoing development and expansion of trauma centers in the United States necessitates empirical analysis of the effect of investment in such resources on population-level health outcomes. Multiple linear regressions were performed to predict state-level trauma-related mortality among adults and the elderly across 50 US states in 2010. The number of trauma centers per capita in each state and the percentage of each state's population living within 45-min of a trauma center served as the key independent variables and injury-related mortality served as the dependent variable. All analyses were stratified by age (adult versus elderly; elderly ≥ 65 years old) and were performed in SPSS. The proportion of a population with geographic proximity to a trauma center demonstrates a consistent inverse linear relationship to injury-related mortality. The relationship reliably retains its significance in models including demographic covariates. Interestingly, access to Levels I and II trauma centers demonstrates a stronger correlation with mortality than was observed with Level III centers. Trauma center access is associated with reduced trauma-related mortality among both adults and the elderly as measured by state reported mortality rates. Ongoing efforts to designate and verify new trauma centers, particularly in poorly-served 'trauma deserts', could lead to lower mortality for large populations.
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content type line 23
Indicates joint first authorship.
ISSN:1741-3842
1741-3850
DOI:10.1093/pubmed/fdx156