@article{ref1,
title="Sparsity of burn centers and prolonged length of hospital stay: a nationwide study",
journal="Burns: journal of the International Society for Burn Injuries",
year="2021",
author="Sato, Yukio and Yamamoto, Ryo and Sasaki, Junichi",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: The optimal distribution of burn centers remains unclear. We aimed to determine the appropriate number of burn centers per population (density) and examined a nationwide registry with the hypothesis that low-density burn centers would be associated with unfavorable outcomes. <br><br>PATIENTS AND METHODS: A retrospective study was conducted using the Japanese Society of Burn Injury registry (2011-2021). Burn center density was defined as the number of burn centers per one million population in each prefecture, and centers were trisected on the basis of density. Hospital-free days until day 30 were compared between patients at high-, middle-, and low-density centers. Inverse probability weighting was conducted to adjust baseline characteristics, including age, burn mechanism, and burn severity. <br><br>RESULTS: We included 6764, 6209, and 2200 patients at high-, middle-, and low-density burn centers, respectively. After adjusting for patient demographics and burn severity, patients at high- and middle-density centers (≥0.4 centers per one million population) had longer hospital-free days compared with those at low-density centers (11 [0-23] vs 11 [0-23] vs 8 [0-22] days; p < 0.001). <br><br>CONCLUSIONS: Low burn center density (<0.4 centers per one million population) was associated with longer hospital stay, whereas no higher limit was determined.<p /> <p>Language: en</p>",
language="en",
issn="0305-4179",
doi="10.1016/j.burns.2021.08.014",
url="http://dx.doi.org/10.1016/j.burns.2021.08.014"
}