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Journal Article

Citation

Edwards SR, Chamoun G, Hecox E, Brown MI, Hoppe IC, Arnold PB, Humphries LS. J. Burn Care Res. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irad139

PMID

37698243

Abstract

Specialized burn centers are critical in minimizing burn-associated morbidity and mortality. However, American Burn Association (ABA)-verified burn centers are unequally distributed across the U.S., and fewer centers are available for pediatric patients relative to adults. The economic burden of transport to these centers contributes significantly to the high cost of burn care. This study quantifies inequitable burn care access in the contiguous U.S. due to age group and location as a function of physical proximity to a verified burn center and transportation cost. County-level distances to the nearest verified adult or pediatric burn center were determined and mapped. Distance calculations for each population were combined with transport cost data (2022 CMS Ambulance Fee Schedules) to estimate transportation costs for each population (adult versus pediatric, urban versus rural). Pediatric patients reside 30.5 miles further than adults from the nearest center, significantly increasing transportation costs. Ground and Air transport costs also increased for rural versus urban patients. Notably, rural patients face almost double the cost of air transport. While physical proximity to burn care appears to differ only modestly across age and region, this marginal increase in distance is associated with significant economic impact. This study highlights physical and economic barriers to burn care access faced by rural and pediatric patients and underscores the critical need to improve equity in burn care access.. Future studies should expand on this report's findings to more fully characterize additional costs associated with inequitable burn care access.


Language: en

Keywords

Burn Care Access; Health Disparities; Pediatric Burn Centers; Rural Burn Care; Verified Burn Centers

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