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Access to advanced-level hospital care: differences in prehospital times calculated using incident locations compared with patients’ usual residence
  1. Gabrielle Davie1,
  2. Rebbecca Lilley1,
  3. Brandon de Graaf1,
  4. Bridget Dicker2,3,
  5. Charles Branas4,
  6. Shanthi Ameratunga5,6,
  7. Ian Civil7,
  8. Papaarangi Reid8,
  9. Bridget Kool5
  1. 1 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  2. 2 St John New Zealand, Auckland, New Zealand
  3. 3 Department of Paramedicine, Auckland University of Technology, Auckland, New Zealand
  4. 4 Department of Epidemiology, Columbia University in the City of New York, New York, New York, USA
  5. 5 School of Population Health, The University of Auckland, Auckland, New Zealand
  6. 6 Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
  7. 7 Trauma Services, Auckland District Health Board, Auckland, New Zealand
  8. 8 Te Kupenga Hauora Maori, University of Auckland, Auckland, New Zealand
  1. Correspondence to Associate Professor Gabrielle Davie, Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand; gabrielle.davie{at}otago.ac.nz

Abstract

Studies estimate that 84% of the USA and New Zealand’s (NZ) resident populations have timely access (within 60 min) to advanced-level hospital care. Our aim was to assess whether usual residence (ie, home address) is a suitable proxy for location of injury incidence. In this observational study, injury fatalities registered in NZ’s Mortality Collection during 2008–2012 were linked to Coronial files. Estimated access times via emergency medical services were calculated using locations of incident and home. Using incident locations, 73% (n=4445/6104) had timely access to care compared with 77% when using home location. Access calculations using patients’ home locations overestimated timely access, especially for those injured in industrial/construction areas (18%; 95% CI 6% to 29%) and from drowning (14%; 95% CI 7% to 22%). When considering timely access to definitive care, using the location of the injury as the origin provides important information for health system planning.

  • geographical/spatial analysis
  • prehospital
  • mortality
  • injury diagnosis

Data availability statement

The primary data used for this study was obtained from New Zealand’s Mortality Collection and the Victorian Department of Justice and Community Safety’s National Coronial Information System in Australia. Neither of these collections are publicly available. Requests for data can be sent to data-enquiries@health.govt.nz and/or ncis@ncis.org.au.

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Data availability statement

The primary data used for this study was obtained from New Zealand’s Mortality Collection and the Victorian Department of Justice and Community Safety’s National Coronial Information System in Australia. Neither of these collections are publicly available. Requests for data can be sent to data-enquiries@health.govt.nz and/or ncis@ncis.org.au.

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Footnotes

  • Contributors GD: funding acquisition, conceptualisation, methodology, formal analysis and writing—original draft. RL: funding acquisition, conceptualisation and writing—review and editing. BdG: data curation and software. BD, CB, IC and PR: funding acquisition and writing—review and editing. BK: funding acquisition, conceptualisation, writing—review and editing and project administration.

  • Funding This work was supported by Health Research Council of New Zealand project grant (HRC 15/186).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

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