描述美国15个最大城市中高级创伤中心的密度。
Describing the density of high-level trauma centers in the 15 largest US cities.
作者信息
Stey Anne M, Byskosh Alexandria, Etkin Caryn, Mackersie Robert, Stein Deborah M, Bilimoria Karl Y, Crandall Marie L
机构信息
Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Surgery, University of California San Francisco, San Francisco, California, USA.
出版信息
Trauma Surg Acute Care Open. 2020 Oct 9;5(1):e000562. doi: 10.1136/tsaco-2020-000562. eCollection 2020.
BACKGROUND
There has been a proliferation of urban high-level trauma centers. The aim of this study was to describe the density of high-level adult trauma centers in the 15 largest cities in the USA and determine whether density was correlated with urban social determinants of health and violence rates.
METHODS
The largest 15 US cities by population were identified. The American College of Surgeons' (ACS) and states' department of health websites were cross-referenced for designated high-level (levels 1 and 2) trauma centers in each city. Trauma centers and associated 20 min drive radius were mapped. High-level trauma centers per square mile and per population were calculated. The distance between high-level trauma centers was calculated. Publicly reported social determinants of health and violence data were tested for correlation with trauma center density.
RESULTS
Among the 15 largest cities, 14 cities had multiple high-level adult trauma centers. There was a median of one high-level trauma center per every 150 square kilometers with a range of one center per every 39 square kilometers in Philadelphia to one center per596 square kilometers in San Antonio. There was a median of one high-level trauma center per 285 034 people with a range of one center per 175 058 people in Columbus to one center per 870 044 people in San Francisco. The median minimum distance between high-level trauma centers in the 14 cities with multiple centers was 8 kilometers and ranged from 1 kilometer in Houston to 43 kilometers in San Antonio. Social determinants of health, specifically poverty rate and unemployment rate, were highly correlated with violence rates. However, there was no correlation between trauma center density and social determinants of health or violence rates.
DISCUSSION
High-level trauma centers density is not correlated with social determinants of health or violence rates.
LEVEL OF EVIDENCE
VI.
STUDY TYPE
Economic/decision.
背景
城市高级创伤中心数量激增。本研究旨在描述美国15个最大城市中高级成人创伤中心的密度，并确定密度是否与城市健康和暴力率的社会决定因素相关。
方法
确定美国人口最多的15个城市。交叉参考美国外科医师学会（ACS）和各州卫生部门网站，以获取每个城市指定的高级（1级和2级）创伤中心。绘制创伤中心及其相关的20分钟车程半径图。计算每平方英里和每人口的高级创伤中心数量。计算高级创伤中心之间的距离。测试公开报告的健康和暴力数据的社会决定因素与创伤中心密度的相关性。
结果
在15个最大城市中，14个城市有多个高级成人创伤中心。每150平方公里中位数有一个高级创伤中心，范围从费城每39平方公里一个中心到圣安东尼奥每596平方公里一个中心。每285034人中位数有一个高级创伤中心，范围从哥伦布每175058人一个中心到旧金山每870044人一个中心。在有多个中心的14个城市中，高级创伤中心之间的中位数最小距离为8公里，范围从休斯顿的1公里到圣安东尼奥的43公里。健康的社会决定因素，特别是贫困率和失业率，与暴力率高度相关。然而，创伤中心密度与健康或暴力率的社会决定因素之间没有相关性。
讨论
高级创伤中心密度与健康或暴力率的社会决定因素无关。
证据水平
VI。
研究类型
经济/决策。
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