Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Disaster Med Public Health Prep. 2012 Jun;6(2):117-25. doi: 10.1001/dmp.2012.28.
The objective is to describe by geographic proximity the extent to which the US pediatric population (aged 0-17 years) has access to pediatric and other specialized critical care facilities, and to highlight regional differences in population and critical resource distribution for preparedness planning and utilization during a mass public health disaster.
The analysis focused on pediatric hospitals and pediatric and general medical/surgical hospitals with specialized pediatric critical care capabilities, including pediatric intensive care units (PICU), pediatric cardiac ICUs (PCICU), level I and II trauma and pediatric trauma centers, and general and pediatric burn centers. The proximity analysis uses a geographic information system overlay function: spatial buffers or zones of a defined radius are superimposed on a dasymetric map of the pediatric population. By comparing the population living within the zones to the total population, the proportion of children with access to each type of specialized unit can be estimated. The project was conducted in three steps: preparation of the geospatial layer of the pediatric population using dasymetric mapping methods; preparation of the geospatial layer for each resource zone including the identification, verification, and location of hospital facilities with the target resources; and proximity analysis of the pediatric population within these zones.
Nationally, 63.7% of the pediatric population lives within 50 miles of a pediatric hospital; 81.5% lives within 50 miles of a hospital with a PICU; 76.1% lives within 50 miles of a hospital with a PCICU; 80.2% lives within 50 miles of a level I or II trauma center; and 70.8% lives within 50 miles of a burn center. However, state-specific proportions vary from less than 10% to virtually 100%. Restricting the burn and trauma centers to pediatric units only decreases the national proportion to 26.3% for pediatric burn centers and 53.1% for pediatric trauma centers.
This geospatial analysis describes the current state of pediatric critical care hospital resources and provides a visual and analytic overview of existing gaps in local pediatric hospital coverage. It also highlights the use of dasymetric mapping as a tool for public health preparedness planning.
描述美国儿科人口（0-17 岁）获得儿科和其他专科重症监护设施的地理接近程度，并强调人口和关键资源分布的区域差异，以便为大规模公共卫生灾害期间的准备规划和利用做好准备。
该分析集中在儿科医院和具有专科儿科重症监护能力的儿科和普通医疗/外科医院，包括儿科重症监护病房（PICU）、儿科心脏重症监护病房（PCICU）、一级和二级创伤和儿科创伤中心，以及普通和儿科烧伤中心。接近度分析使用地理信息系统叠加功能：将定义半径的空间缓冲区或区域叠加在儿科人口的 dasymetric 地图上。通过比较居住在区域内的人口与总人口，可估计获得每种专科单位的儿童比例。该项目分三个步骤进行：使用 dasymetric 制图方法准备儿科人口的地理空间层；准备每个资源区域的地理空间层，包括识别、验证和定位具有目标资源的医院设施；以及在这些区域内进行儿科人口的接近度分析。
全国范围内，63.7%的儿科人口居住在距离儿科医院 50 英里以内的地方；81.5%的人居住在距离拥有 PICU 的医院 50 英里以内的地方；76.1%的人居住在距离拥有 PCICU 的医院 50 英里以内的地方；80.2%的人居住在距离一级或二级创伤中心 50 英里以内的地方；70.8%的人居住在距离烧伤中心 50 英里以内的地方。然而，各州的比例差异从不足 10%到几乎 100%不等。仅将烧伤和创伤中心限制为儿科单位，会将全国儿科烧伤中心的比例降低到 26.3%，儿科创伤中心的比例降低到 53.1%。
这项地理空间分析描述了儿科重症监护医院资源的现状，并提供了现有儿科医院覆盖范围的直观和分析概述。它还强调了使用 dasymetric 制图作为公共卫生准备规划工具的重要性。
