M. B. Bhatia1, M. Aranke1, T. Dang1, D. Vyas1 1Texas Tech University Health Science Center,Department Of Surgery,Lubbock, TEXAS, USA
Introduction:
Surgical intervention, especially trauma surgery, has gained traction in the public health community in the recent past, with factors such as surgeon density starting to gain consideration in medical and scientific research. Similar work has yet to be completed in regards to pre-hospital care that the trauma victim receives by way of first responders. Multiple studies have shown that prompt, well-executed pre-hospital care by first responders can lead to a reduction in mortality, in both urban and rural settings. Even though the importance of first responders is widely agreed upon by the healthcare and public health community, no mathematical model currently exists that gives a reliable estimate of the number of first responders a certain community needs at a given period in time.
Objective:
Propose a pilot model aimed at quantifying the number of first responders needed in a particular geographic area.
Methods:
Fifteen states that were more than 50% rural were selected. Comparisons among the states were made across 11 measures: population density, surgeon density, hospital density, median age, male-female driver ratio, drivers <25 years, drivers >75 years, passenger car mortality, pick-up & SUV mortality, motorcycle mortality, and speeding-related traffic fatality. The comparison among three states—Wyoming, Montana, and Idaho— met the target match rate >50%. The three states demonstrated the relationship between first responder and MVA mortality.
Results:
Statistical data for Wyoming, Montana, and Idaho in 2010 were collected from the United States Bureau of Labor Statistics and the Highway Loss Data Institute, respectively, and plotted on a scatterplot. A best-fit line was created, yielding the linear relationship modeled by the equation y = -4.473x + 27.979. Based on this equation, 3.5 first responders per square mile are needed in these states to reach the Healthy People 2020 Target of 12.4 motor vehicle deaths per 100,000, assuming that the contributions of the matched factors remain constant.
Conclusion:
Multiple studies have shown that prompt and well-executed pre-hospital care can lead to a significant reduction in mortality, both in urban and in rural settings. The proposed model demonstrates a clear inverse relationship between first responder density and MVA mortality. Since we could not find 100% match between any states and could only find 64% match between three states, the resulting relationship is likely still significantly influenced by unknown confounding factors. Further modeling efforts could elucidate these factors and ultimately, lead to better allocation of public health resources.
