The impact of variation in trauma care times: urban versus rural.
Prehosp Disaster Med
; 10(3): 161-6; discussion 166-7, 1995.
Article
en En
| MEDLINE
| ID: mdl-10155424
STUDY OBJECTIVES: To document the existence and nature of variation in times to trauma care between urban and rural locations; to assess the impact of identified variations on outcome. DESIGN: Retrospective case review. SETTING: Washington state, 1986. PARTICIPANTS: Motor-vehicle-collision fatalities. METHODS: Previously unreported definitions of urban and rural location and possibly preventable death were used to conduct a comparative analysis of urban and rural fatalities. Trauma care times in the prehospital and the emergency department (ED) phases of care were abstracted. Their relationships to corresponding crude death rates and possibly preventable death rates also were examined. RESULTS: Prehospital times averaged two times longer in rural locations than in urban areas. Fist-physician contact in the ED averaged six times longer in rural locations than in urban settings. Concomitantly, the crude death rate in rural settings was three times that of the urban areas. The overall possibly preventable death rate was double the urban rates in rural incidents. When stratified by phase of care, rate of possibly preventable death showed no urban/rural variation for the prehospital phase, but was three times greater for the ED phase in rural areas than in urban ones. CONCLUSIONS: Trauma care times and adverse outcome appear to be associated. Allocation of resources to decrease length of and geographic variation in time to definitive care, particularly in the ED phase, seems appropriate.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Accidentes de Tránsito
/
Salud Rural
/
Salud Urbana
/
Servicios Médicos de Urgencia
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Prehosp Disaster Med
Asunto de la revista:
MEDICINA DE EMERGENCIA
Año:
1995
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos