University of Surrey

Test tubes in the lab Research in the ATI Dance Research

Access to specialist care: Optimizing the geographic configuration of trauma systems.

Jansen, JO, Morrison, JJ, Wang, H, He, S, Lawrenson, R, Hutchison, JD and Campbell, MK (2015) Access to specialist care: Optimizing the geographic configuration of trauma systems. J Trauma Acute Care Surg, 79 (5). pp. 756-765.

Full text not available from this repository.

Abstract

BACKGROUND: The optimal geographic configuration of health care systems is key to maximizing accessibility while promoting the efficient use of resources. This article reports the use of a novel approach to inform the optimal configuration of a national trauma system. METHODS: This is a prospective cohort study of all trauma patients, 15 years and older, attended to by the Scottish Ambulance Service, between July 1, 2013, and June 30, 2014. Patients underwent notional triage to one of three levels of care (major trauma center [MTC], trauma unit, or local emergency hospital). We used geographic information systems software to calculate access times, by road and air, from all incident locations to all candidate hospitals. We then modeled the performance of all mathematically possible network configurations and used multiobjective optimization to determine geospatially optimized configurations. RESULTS: A total of 80,391 casualties were included. A network with only high- or moderate-volume MTCs (admitting at least 650 or 400 severely injured patients per year, respectively) would be optimally configured with a single MTC. A network accepting lower-volume MTCs (at least 240 severely injured patients per year) would be optimally configured with two MTCs. Both configurations would necessitate an increase in the number of helicopter retrievals. CONCLUSION: This study has shown that a novel combination of notional triage, network analysis, and mathematical optimization can be used to inform the planning of a national clinical network. Scotland's trauma system could be optimized with one or two MTCs. LEVEL OF EVIDENCE: Care management study, level IV.

Item Type: Article
Authors :
NameEmailORCID
Jansen, JOUNSPECIFIEDUNSPECIFIED
Morrison, JJUNSPECIFIEDUNSPECIFIED
Wang, Hhanding.wang@surrey.ac.ukUNSPECIFIED
He, SUNSPECIFIEDUNSPECIFIED
Lawrenson, RUNSPECIFIEDUNSPECIFIED
Hutchison, JDUNSPECIFIEDUNSPECIFIED
Campbell, MKUNSPECIFIEDUNSPECIFIED
Date : November 2015
Identification Number : https://doi.org/10.1097/TA.0000000000000827
Uncontrolled Keywords : Adult, Aged, Aged, 80 and over, Cohort Studies, Delivery of Health Care, Emergency Medical Services, Emergency Service, Hospital, Female, Geography, Health Services Accessibility, Health Services Needs and Demand, Humans, Information Systems, Injury Severity Score, Male, Middle Aged, Outcome Assessment (Health Care), Prospective Studies, Scotland, Specialization, Trauma Centers, Triage, Wounds and Injuries
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 13:44
Last Modified : 17 May 2017 15:12
URI: http://epubs.surrey.ac.uk/id/eprint/840221

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year


Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800