T. Uribe Leitz1, M. M. Esquivel1, N. Y. Garland1, L. M. Knowlton1, K. L. Staudenmayer1, D. A. Spain1, T. G. Weiser1 1Stanford University,Department Of Surgery, Section Of Acute Care Surgery,STANFORD, CA, USA
Introduction: Due to its expanse, geography, and population distribution, critically injured patients in California could face a challenge in access to trauma centers. We seek to apply geospatial techniques to analyze access to trauma center care in California from a geographic perspective. Understanding how trauma centers and populations are distributed could help identify areas of particular need or areas at risk of being underserved.
Methods: We obtained information on trauma center designation and location from the American Trauma Society-Trauma Information Exchange Program (TIEP, 2014) and the California Office of Statewide Health Planning and Development (OSHPD, 2014). We analyzed time and distance to these centers, and the proportion of the population covered within 1-hour travel time. We used OpenStreetMaps to determine driving times and LandScan 2014 Global Population Database (ORNL-US DoD) to geolocate population density within the state. Data were analyzed and images generated in Redivis (Mountain View, CA), a data visualization platform.
Results: A total of 74 trauma centers were identified for California. Of these, 15 (20.3%) were Level I, 37 (50%) were Level II, 14 (18.9%) were Level III, and 8 (10.8%) were Level IV. The majority of the population, 95.2% (36.9 million people) live within 1-hour of a Level I or II trauma center (Figure 1); only 1.4 million people live outside a hospital designated as a trauma center (Level I-IV).
Conclusions: The vast majority of Californians can access a Level I or II trauma center by road within an hour, but over 1 million people live outside of a one-hour road network to a trauma facility. Geospatial analyses and visualization tools assist in the evaluation of trauma systems, help identify populations without timely access to life saving trauma care, and inform state EMS to support trauma center designation, particularly in more remote areas, as a complement of a larger needs-based assessment of trauma systems.
