Citation

Anderson ES, Greenwood-Ericksen M, Wang NE, Dworkis DA. Am. J. Emerg. Med. 2019; ePub(ePub): ePub.

Affiliation

University of Southern California, Los Angeles County Hospital, Department of Emergency Medicine, United States of America.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.ajem.2019.02.030

PMID

30824273

Abstract

BACKGROUND: Trauma is a major cause of death and disability in the United States, and significant disparities exist in access to care, especially in non-urban settings. From 2007 to 2017 New Mexico expanded its trauma system by focusing on building capacity at the hospital level.

METHODS: We conducted a geospatial analysis at the census block level of access to a trauma center in New Mexico within 1 h by ground or air transportation for the years 2007 and 2017. We then examined the characteristics of the population with access to care. A multiple logistic regression model assessed for remaining disparities in access to trauma centers in 2017.

RESULTS: The proportion of the population in New Mexico with access to a trauma center within 1 h increased from 73.8% in 2007 to 94.8% in 2017. The largest increases in access to trauma care within 1 h were found among American Indian/Alaska Native populations (AI/AN) (35.2%) and people living in suburban areas (62.9%). In 2017, the most rural communities (aOR 58.0), communities on an AI/AN reservation (aOR 25.6), communities with a high proportion of Hispanic/Latino persons (aOR 8.4), and a high proportion of elderly persons (aOR 3.2) were more likely to lack access to a trauma center within 1 h.

CONCLUSION: The New Mexico trauma system expansion significantly increased access to trauma care within 1 h for most of New Mexico, but some notable disparities remain. Barriers persist for very rural parts of the state and for its sizable American Indian community.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

American Indian; Health disparities; Rural health; Trauma