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338785
Rural Trauma Center Utilization for Severe Injuries Disparity Research


Sunday, November 1, 2015

Sebastiana Gianci, Agency for Healthcare Research and Quality (AHRQ), Rockville, MD
Barbara A. Barton, MPH, Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, MD
Ernest Moy, MA, MPH, Center for Quality Improvement and Patient Safety (CQuIPS), Agency for Healthcare Research and Quality, Rockville,, MD
Background/Purpose: Trauma Center Utilization is critical to preventing, reducing the impact of, and avoiding deaths from many injuries and other emergency occurrences. CDC notes that “Injuries kill more than 180,000 people each year—that’s 1 death every 3 minutes”. Furthermore, significant disparities exist for racial, ethnic, age and geographic groups. The 2014 National Healthcare Quality and Disparities Reports (NHQDR) include a focus on Rural Disparities as a priority population.

Methods:  Six methods based on the 2013 NCHS Urban-Rural Classification Scheme were used to assess disparities by residence location.  Methods include (1) two-part significance testing for most recent year, (2) trending over time and (3) gap analysis. Data source was AHRQ Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2012. One of many rural measures studied was Trauma Center Utilization for Severe Injuries , by residence location, 2012

Results/Outcomes

Our research on rural patients with severe injuries suggest they are treated in Level I or II Trauma Centers; however, access to trauma centers may be more difficult for residents of rural area.

Conclusion:

Groups With Disparities:  Residents of micropolitan and noncore areas with severe injuries were less likely to be treated in Level I or II Trauma Centers  and more likely to be treated in non-trauma emergency departments compared with residents of large fringe metropolitan areas (suburbs), but some of these difference were not statistically significant due to small sample sizes.

Learning Areas:

Clinical medicine applied in public health
Diversity and culture
Provision of health care to the public
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss a multiplicity of disparity topics, in addition to numbers of trauma centers in rural localities, that may impact this specific disparity for residents of rural areas.

Keyword(s): Emergency Medical Services, Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am responsible for because: I am a member of the production team of the US Agency for Healthcare Research and Quality's National Healthcare Quality and Disparities Reports, and I am versed in statistical analysis and presentation of health care quality and disparities data and trending. Any relevant financial relationships? No
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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