Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne VIC 3004, Australia; Department of Physiotherapy, Epworth Hospital, Melbourne, 50 Burwood Rd, Hawthorn VIC 3122, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne VIC 3004, Australia.
Injury. 2022 May;53(5):1707-1715. doi: 10.1016/j.injury.2021.12.011. Epub 2021 Dec 24.
Post-discharge healthcare needs are complex and persistent for people following major trauma. A number of geographic barriers to accessing healthcare exist, particularly for people in regional areas. The aim of this study was to explore regional variation in the distances travelled to access health services and identify patterns of health service use in the first three years following transport-related major trauma.
This registry-based cohort study used linked data from the Victorian State Trauma Registry (VSTR) and the Transport Accident Commission (TAC). Victorians who sustained major trauma from a transport-related event between January 1 2006 and December 31 2016, with at least three years of follow-up TAC claims data were included in the study. Geospatial mapping of the median distance travelled to medical and allied health services was conducted for each Victorian Local Government Area.
In the first three years post-discharge, 4,964 people (75.6%) visited a general practitioner, 5058 (77.0%) saw other medical professionals, 2269 (34.6%) accessed mental health services, 2154 (32.8%) saw an occupational therapist and 4404 (67.0%) attended a physical therapy service. Geospatial mapping revealed that people in regional Local Government Area travelled further distances to access health services. Specific clustering of increased travel distances was observed in regional areas of the far west and north-east of Victoria. The number of people using services declined with each subsequent year beyond hospital discharge. However, the number of trips were consistent over time for those still engaged in services.
Distances travelled to access health services vary across geographic regions and may result in an increased travel burden for those in some regional Local Government Area. Understanding gaps in health services by geographic region can assist to improve service availability. Alternate service delivery methods, such as telehealth, may assist to reduce the associated burden of travel for those in regional areas.
重大创伤后患者的出院后医疗需求复杂且持续存在。由于存在一些地理障碍，特别是对于地区居民而言，他们在获得医疗服务方面面临着许多困难。本研究旨在探讨在获取医疗服务方面的地域差异，并确定在交通相关重大创伤后前三年的卫生服务使用模式。
本基于登记的队列研究使用了维多利亚州创伤登记处（VSTR）和运输事故委员会（TAC）的相关数据。研究纳入了 2006 年 1 月 1 日至 2016 年 12 月 31 日期间因交通相关事件而发生重大创伤的维多利亚州居民，这些患者在 TAC 理赔数据中至少有三年的随访记录。对每个维多利亚州地方政府区域内前往医疗和辅助医疗服务的中位数距离进行了地理空间映射。
在出院后的前三年中，4964 人（75.6％）看了全科医生，5058 人（77.0％）看了其他医疗专业人员，2269 人（34.6％）接受了心理健康服务，2154 人（32.8％）看了职业治疗师，4404 人（67.0％）参加了物理治疗服务。地理空间映射显示，地区居民前往卫生服务机构的距离更远。在维多利亚州远西部和东北部的地区观察到特定的旅行距离增加聚类。在出院后的后续年份中，使用服务的人数呈下降趋势。但是，对于那些仍在使用服务的人来说，就诊次数保持稳定。
在获取卫生服务方面，距离因地理位置而异，这可能会增加某些地区地方政府区域居民的旅行负担。了解地理区域内的卫生服务差距可以帮助改善服务的可获得性。替代服务交付方法，例如远程医疗，可能有助于减轻地区居民的相关旅行负担。
