Geography of the Underserved
Rattachement africain : us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: To determine the proportion and characteristics of injured rural residents treated at urban trauma centers (TCs), urban non-trauma centers (NTCs), rural TCs, and rural NTCs. SUMMARY BACKGROUND DATA: Timely treatment at a designated TC improves outcomes for patients with serious injuries, but rural residents have limited access to designated TCs. Rural NTCs may constitute an under-recognized source of TC. METHODS: We used the National Emergency Department Sample to conduct a retrospective, pooled cross-sectional study of ED visits among rural residents with injury severity score (ISS) ≥ 9 (indicating at least moderate injury). Hospitals were designated as TC or NTC and as rural or urban. We compared management, disposition, and outcomes among hospital types. RESULTS: Of 748,587 injured rural residents from 2016 to 2020, 384,113 (51.3%) were treated in rural NTCs, 232,845 (31.1%) in urban TCs, 116,493 (15.6%) in urban NTCs, and 15,137 (2.0%) in rural TCs. Injuries treated at rural NTCs were moderate in severity (ISS: 9-15) in 76.6% of visits, severe (ISS: 16-25) in 15.7%, and very severe (ISS: >25) in 1.1%. Urban TCs saw the highest proportion of very severe injuries (17.3%). Rural NTCs managed 77.5% of visits definitively, discharging 72.8%. They transferred 21.9% of patients. The length of stay was the longest, and hospital charges were highest for patients treated in urban TCs, which also performed the most procedures. Rural NTCs had the shortest length of stay and lowest mean charges. CONCLUSIONS: Rural NTCs provided initial care for more than half of injured rural residents, including 2 in 5 of those with the most severe injuries, and managed more than 3 in 4 definitively. These hospitals may be an under-recognized component of the US trauma system.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Geography of the Underserved
- Date Crossref
- 18/09/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Leonard Davis Institute of Health Economics Surgical Critical Care pays non établi dans la noticeStructure de recherche
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University of Pennsylvania and Emergency Surgery and Leonard Davis Institute of Health Economics pays non établi dans la noticeUniversité ou école supérieure
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University of California Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Hospital of the University of Pennsylvania pays non établi dans la noticeÉtablissement de santé
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University of Pittsburgh Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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University of Minnesota Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
Surgical Critical Care — Leonard Davis Institute of Health Economics, and Emergency Surgery and Leonard Davis Institute of Health Economics — University of Pennsylvania et Department of Surgery — University of California, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.