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Preventable injury deaths: identifying opportunities to improve timeliness and reach of emergency healthcare services in New Zealand
  1. Rebbecca Lilley1,
  2. Bridget Kool2,
  3. Gabrielle Davie1,
  4. Brandon de Graaf1,
  5. Shanthi N Ameratunga2,
  6. Pararangi Reid3,
  7. Ian Civil4,
  8. Bridget Dicker5,6,
  9. Charles C Branas7,8
  1. 1 Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
  2. 2 Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
  3. 3 Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  4. 4 Trauma Services, Auckland District Health Board, Auckland, New Zealand
  5. 5 St John, Mt Wellington, Auckland, New Zealand
  6. 6 Department of Paramedicine, Auckland University of Technology, Auckland, New Zealand
  7. 7 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
  8. 8 Biostatistics and Epidemiology Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
  1. Correspondence to Dr Rebbecca Lilley, Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin 9054, New Zealand; rebbecca.lilley{at}


Background Traumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival.

Objective This cross-sectional study will investigate the epidemiology and geographic location of prehospital fatal injury deaths in relation to access to prehospital emergency services for the first time in New Zealand.

Design and study population Electronic Coronial case files for the period 2008–2012 will be reviewed to identify cases of prehospital fatal injury across New Zealand.

Methods The project will combine epidemiological and geospatial methods in three research phases: (1) identification, enumeration, description and geocoding of prehospital injury deaths using existing electronic injury data sets; (2) geocoding of advanced hospital-level care providers and emergency land and air ambulance services to determine the current theoretical service coverage in a specified time period and (3) synthesising of information from phases I and II using geospatial methods to determine the number of prehospital injury deaths located in areas without timely access to advanced-level hospital care.

Discussion The findings of this research will identify opportunities to optimise access to advanced-level hospital care in New Zealand to increase the chances of survival from serious injury. The resulting epidemiological and geospatial analyses will represent an advancement of knowledge for injury prevention and health service quality improvement towards better patient outcomes following serious injury in New Zealand and similar countries.

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  • Contributors RL was the lead author and is guarantor of this paper. RL drafted the paper. All authors contributed to the study design, interpretation of the results and the review and editing of the manuscript. All authors approved the submitted manuscript.

  • Funding This project is funded by a Health Research Council of New Zealand project grant (HRC 15/186).

  • Competing interests None declared.

  • Ethics approval University of Auckland Human Participants Ethics Committee (ref 016179), National Coronial Information System (ref NZ007) and Health and Disability Ethics Committee (ref OTA/99/02/008/AM05).

  • Provenance and peer review Not commissioned; externally peer reviewed.