Michael Wandling1, Jess Behrens1, Renee Hsia2, Marie Crandall3. 1. Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 650, Chicago, IL 60611, USA. 2. Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA. 3. Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 650, Chicago, IL 60611, USA. Electronic address: marie.crandall@jax.ufl.edu.
Abstract
BACKGROUND: Timely transport to designated trauma centers impacts mortality following serious injury. We examined whether the distribution of trauma centers in Chicago has created disparities in access to trauma care. METHODS: Using the Illinois State Trauma Registry, locations of Chicago-area gunshot wounds (GSWs) from 1999 to 2009 were geocoded and transport times were analyzed for pediatric (age ≤ 15) and adult (age ≥ 16) GSWs. RESULTS: A total of 11,744 included pediatric and adult GSWs were analyzed. Adults experienced longer mean transport times (11.3 vs 10.2 minutes, P < .001). Disproportionate numbers of adult GSW victims experienced over 30-minute transport times on Chicago's south side. Pediatric GSWs demonstrated no such disparity, likely attributable to the presence of a pediatric trauma center on the southeast side. CONCLUSIONS: Geographic disparities in access to trauma care exist even within urban trauma systems. The absence of an adult trauma center on Chicago's southeast side has contributed to these disparities.
BACKGROUND: Timely transport to designated trauma centers impacts mortality following serious injury. We examined whether the distribution of trauma centers in Chicago has created disparities in access to trauma care. METHODS: Using the Illinois State Trauma Registry, locations of Chicago-area gunshot wounds (GSWs) from 1999 to 2009 were geocoded and transport times were analyzed for pediatric (age ≤ 15) and adult (age ≥ 16) GSWs. RESULTS: A total of 11,744 included pediatric and adult GSWs were analyzed. Adults experienced longer mean transport times (11.3 vs 10.2 minutes, P < .001). Disproportionate numbers of adult GSW victims experienced over 30-minute transport times on Chicago's south side. Pediatric GSWs demonstrated no such disparity, likely attributable to the presence of a pediatric trauma center on the southeast side. CONCLUSIONS: Geographic disparities in access to trauma care exist even within urban trauma systems. The absence of an adult trauma center on Chicago's southeast side has contributed to these disparities.
Authors: W Andrew Smedley; K Lorraine Stone; John Killian; Allison Brown; Paige Farley; Russell L Griffin; Daniel B Cox; Jeffrey D Kerby; Jan O Jansen Journal: Am Surg Date: 2019-09-01 Impact factor: 0.688
Authors: Nicolas W Medrano; Cynthia Lizette Villarreal; Michelle A Price; Ellen MacKenzie; Kurt B Nolte; Monica J Phillips; Ronald M Stewart; Brian J Eastridge Journal: Trauma Surg Acute Care Open Date: 2019-04-11