Access to advanced-level hospital care: differences in prehospital times calculated using incident locations compared with patients' usual residence.
Gabrielle DavieRebbecca LilleyBrandon de GraafBridget DickerCharles BranasShanthi AmeratungaIan CivilPapaarangi ReidBridget KoolPublished in: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention (2021)
Studies estimate that 84% of the USA and New Zealand's (NZ) resident populations have timely access (within 60 min) to advanced-level hospital care. Our aim was to assess whether usual residence (ie, home address) is a suitable proxy for location of injury incidence. In this observational study, injury fatalities registered in NZ's Mortality Collection during 2008-2012 were linked to Coronial files. Estimated access times via emergency medical services were calculated using locations of incident and home. Using incident locations, 73% (n=4445/6104) had timely access to care compared with 77% when using home location. Access calculations using patients' home locations overestimated timely access, especially for those injured in industrial/construction areas (18%; 95% CI 6% to 29%) and from drowning (14%; 95% CI 7% to 22%). When considering timely access to definitive care, using the location of the injury as the origin provides important information for health system planning.
Keyphrases
- healthcare
- end stage renal disease
- palliative care
- quality improvement
- newly diagnosed
- ejection fraction
- chronic kidney disease
- cardiovascular disease
- prognostic factors
- affordable care act
- risk factors
- peritoneal dialysis
- cardiac arrest
- emergency department
- squamous cell carcinoma
- wastewater treatment
- type diabetes
- molecular dynamics
- radiation therapy
- patient reported outcomes
- mental health
- electronic health record