Chea Heewon, Kim Hyun
Department of Geography, University of Tennessee, Knoxville, Tennessee, United States of America.
PLOS Glob Public Health. 2023 Aug 18;3(8):e0002230. doi: 10.1371/journal.pgph.0002230. eCollection 2023.
Accessibility to trauma centers is vital for the patients of severe motor vehicle crashes. Many vehicle crash fatalities failed to reach the proper emergency medical services since the accident location was far away from trauma centers. The spatial discordance between the service coverage area of trauma centers and actual locations of motor vehicle accidents delays the definitive medical care and results in death or disability. Many fatalities would have been prevented if the patients had a chance to get proper treatment in time at Southeastern region of the U.S. Also, the accessibility to trauma centers from the actual locations of motor vehicle accidents is different in the Southeastern region. This research aimed to facilitate the accessibility to trauma centers for severe motor vehicle crash patients in the Southeastern region. The analyses are conducted to assess current trauma center accessibility and suggest the optimal locations of future trauma centers using the Anti-covering location model for trauma centers (TraCt model). This study found that existing trauma centers failed to serve many demands, and the actual coverages of the current locations of trauma centers over potential demands are highly different in each Southeastern state. TraCt model is applied to each Southeastern state, and its solutions provide better coverage for demand locations. However, the TraCt model for each state tends to choose too many facilities, with excessively supplied facilities across the Southeastern region. The excessive service supply issue is addressed by applying the TraCt Model to a broader spatial extent. TraCt model applied to the entire Southeastern region and most of the demand, over 98% covered by the service coverage of optimal facility locations with 15 additional facilities. This research proves that the GIS and TraCt model applied to the broader spatial extent works well with increasing trauma medical service beneficiaries while providing a minimum number of additional facilities.
对于严重机动车碰撞事故的患者来说，能否到达创伤中心至关重要。许多机动车碰撞事故致死案例是因为事故地点离创伤中心较远，患者未能获得适当的紧急医疗服务。创伤中心的服务覆盖区域与机动车事故实际发生地点之间的空间不协调，导致确定性医疗救治延迟，进而造成死亡或残疾。如果患者有机会在美国东南部及时获得适当治疗，许多死亡本可避免。此外，在美国东南部，从机动车事故实际发生地点到创伤中心的可达性也存在差异。本研究旨在提高美国东南部严重机动车碰撞事故患者前往创伤中心的可达性。通过使用创伤中心反覆盖选址模型（TraCt模型）进行分析，以评估当前创伤中心的可达性，并为未来创伤中心的最佳选址提供建议。研究发现，现有的创伤中心无法满足许多需求，而且在东南部各州，创伤中心当前位置对潜在需求的实际覆盖情况差异很大。TraCt模型应用于东南部各州，其解决方案能为需求地点提供更好的覆盖。然而，各州的TraCt模型往往选择过多设施，导致整个东南部地区设施供应过剩。通过将TraCt模型应用于更广泛的空间范围来解决服务供应过剩问题。将TraCt模型应用于整个东南部地区，大部分需求（超过98%）被最佳设施位置的服务覆盖范围所覆盖，只需增加15个设施。本研究证明，将地理信息系统（GIS）和TraCt模型应用于更广泛的空间范围，在增加创伤医疗服务受益人数的同时，只需提供最少数量的额外设施，效果良好。
