Geographic Information Systems Mapping of Trauma Center Development in Florida

• Published in: The Journal of surgical research Vol. 303; pp. 561 - 567
• Main Authors: Broecker, Justine S., Gross, Christopher, Winchell, Robert, Crandall, Marie
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2024
• Subjects: Geographic information systems mapping; Healthcare disparities; Trauma center ownership; Trauma systems development; Healthcare disparities; Geographic information systems mapping; Trauma systems development; Trauma center ownership
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2024.09.060

There has been a substantial increase in the number of trauma centers (TCs) opened in the US over the past decade which coincided with population increases and policy changes. Our hypotheses were that new TC locations would likely be related to the socioeconomic profile of the surrounding locale—likely favoring higher-income areas—and that hospital ownership status may play a role in the distribution of new centers. Our aim was to use geographic information systems (GIS) analysis to evaluate the growth of an established regional TC and to delineate factors associated with the site chosen for new centers.
ARC-GIS mapping software was utilized to generate a map of all TCs within two Florida metropolitan areas—Jacksonville and Miami. Hospital ownership was classified as for-profit (FP) or government, and opening dates were obtained from publicly available data. US census data (2020) was utilized to add sociodemographic data (race, income, insurance status) by zip code.
The majority of newer TCs opened in Duval/Clay and Dade/Broward counties were FP. GIS mapping demonstrated that 100% of new TCs demonstrated higher mean charges compared to established TC and were located in higher-income neighborhoods where residents were more likely to have health insurance with fewer African-American residents.
Most TCs added to two of the largest metropolitan areas within Florida over the past decade were FP. These TCs demonstrated higher mean charges and tended to be located in areas of higher-income neighborhoods with better insured residents and fewer African-Americans. Such data suggest that more oversight is potentially needed to regulate and organize trauma system development to address trauma need rather than financial incentive alone.