E E Yeap1, J J Morrison2,3, A N Apodaca4, G Egan5, J O Jansen6. 1. General Surgery, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. eeemin@gmail.com. 2. Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK. 3. Academic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, UK. 4. United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA. 5. Scottish Ambulance Service, Edinburgh, UK. 6. General Surgery and Intensive Care Medicine, Aberdeen Royal Infirmary, Ward 34, Foresterhill, Aberdeen, UK. jan.jansen@nhs.net.
Abstract
AIM: The aim of this study was to determine the effect of rurality on the level of destination healthcare facility and ambulance response times for trauma patients in Scotland. METHODS: We used a retrospective analysis of pre-hospital data routinely collected by the Scottish Ambulance Service from 2009-2010. Incident locations were categorised by rurality, using the Scottish urban/rural classification. The level of destination healthcare facility was coded as either a teaching hospital, large general hospital, general hospital, or other type of facility. RESULTS: A total of 64,377 incidents met the inclusion criteria. The majority of incidents occurred in urban areas, which mostly resulted in admission to teaching hospitals. Incidents from other areas resulted in admission to a lower-level facility. The majority of incidents originating in very remote small towns and very remote rural areas were treated in a general hospital. Median call-out times and travel times increased with the degree of rurality, although with some exceptions. CONCLUSIONS: Trauma is relatively rare in rural areas, but patients injured in remote locations are doubly disadvantaged by prolonged pre-hospital times and admission to a hospital that may not be adequately equipped to deal with their injuries. These problems may be overcome by the regionalisation of trauma care, and enhanced retrieval capability.
AIM: The aim of this study was to determine the effect of rurality on the level of destination healthcare facility and ambulance response times for traumapatients in Scotland. METHODS: We used a retrospective analysis of pre-hospital data routinely collected by the Scottish Ambulance Service from 2009-2010. Incident locations were categorised by rurality, using the Scottish urban/rural classification. The level of destination healthcare facility was coded as either a teaching hospital, large general hospital, general hospital, or other type of facility. RESULTS: A total of 64,377 incidents met the inclusion criteria. The majority of incidents occurred in urban areas, which mostly resulted in admission to teaching hospitals. Incidents from other areas resulted in admission to a lower-level facility. The majority of incidents originating in very remote small towns and very remote rural areas were treated in a general hospital. Median call-out times and travel times increased with the degree of rurality, although with some exceptions. CONCLUSIONS:Trauma is relatively rare in rural areas, but patients injured in remote locations are doubly disadvantaged by prolonged pre-hospital times and admission to a hospital that may not be adequately equipped to deal with their injuries. These problems may be overcome by the regionalisation of trauma care, and enhanced retrieval capability.
Authors: Barbara Haas; David Gomez; Brandon Zagorski; Therese A Stukel; Gordon D Rubenfeld; Avery B Nathens Journal: J Am Coll Surg Date: 2010-10-30 Impact factor: 6.113
Authors: A Crawford McGuffie; Colin A Graham; Diana Beard; Jennifer M Henry; Michael O Fitzpatrick; Stewart C Wilkie; Gary W Kerr; Timothy R J Parke Journal: J Trauma Date: 2005-09
Authors: R A Davenport; N Tai; A West; O Bouamra; C Aylwin; M Woodford; A McGinley; F Lecky; M S Walsh; K Brohi Journal: Br J Surg Date: 2010-01 Impact factor: 6.939