Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development

Background The Military Health System must develop and sustain experienced surgical trauma teams while facing decreased surgical volumes both during and between deployments. Military trauma resources may enhance local trauma systems by accepting civilian patients for care at military treatment facil...

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Main Authors: Stacy A Shackelford, Matthew D Tadlock, Blair C Lee, Christian S McEvoy, Dan Ross-Li, Emily A Norris, Shane D Jensen
Format: Article
Language:English
Published: BMJ Publishing Group 2022-10-01
Series:Trauma Surgery & Acute Care Open
Online Access:https://tsaco.bmj.com/content/7/1/e000832.full
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author Stacy A Shackelford
Matthew D Tadlock
Blair C Lee
Christian S McEvoy
Dan Ross-Li
Emily A Norris
Shane D Jensen
author_facet Stacy A Shackelford
Matthew D Tadlock
Blair C Lee
Christian S McEvoy
Dan Ross-Li
Emily A Norris
Shane D Jensen
author_sort Stacy A Shackelford
collection DOAJ
description Background The Military Health System must develop and sustain experienced surgical trauma teams while facing decreased surgical volumes both during and between deployments. Military trauma resources may enhance local trauma systems by accepting civilian patients for care at military treatment facilities (MTFs). Some MTFs may be able to augment their regional trauma systems by developing trauma center (TC) capabilities. The aim of this study was to evaluate the geographical proximity of MTFs to the continental US (CONUS) population and relative to existing civilian adult TCs, and then to determine which MTFs might benefit most from TC development.Methods Publicly available data were used to develop a list of CONUS adult civilian level 1 and level 2 TCs and also to generate a list of CONUS MTFs. Census data were used to estimate adult population densities across zip codes. Distances were calculated between zip codes and civilian TCs and MTFs. The affected population sizes and reductions in distance were tabulated for every zip code that was found to be closer to an MTF than an existing TC.Results 562 civilian adult level 1 and level 2 TCs and 33 military medical centers and hospitals were identified. Compared with their closest civilian TCs, MTFs showed mean reductions in distance ranging from 0 to 30 miles, affecting populations ranging from 12 000 to over 900 000 adults. Seven MTFs were identified that would offer clinically significant reductions in distance to relatively large population centers.Discussion Some MTFs may offer decreased transit times and improved care to large adult populations within their regional trauma systems by developing level 1 or level 2 TC capabilities. The results of this study provide recommendations to focus further study on seven MTFs to identify those that merit further development and integration with their local trauma systems.Level of evidence IV.
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spelling doaj-art-013d1aabff2b4548b2d6153cef3e4cc02024-11-30T05:45:08ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762022-10-017110.1136/tsaco-2021-000832Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center developmentStacy A Shackelford0Matthew D Tadlock1Blair C Lee2Christian S McEvoy3Dan Ross-Li4Emily A Norris5Shane D Jensen6Joint Trauma System, Defense Center of Excellence for Trauma, San Antonio, Texas, USAUS Department of the Navy, Washington, District of Columbia, USADepartment of Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USAIndependent researcher, Norfolk, Virginia, USADepartment of Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Surgery, Joint Trauma System, Joint Base San Antonio, San Antonio, Texas, USABackground The Military Health System must develop and sustain experienced surgical trauma teams while facing decreased surgical volumes both during and between deployments. Military trauma resources may enhance local trauma systems by accepting civilian patients for care at military treatment facilities (MTFs). Some MTFs may be able to augment their regional trauma systems by developing trauma center (TC) capabilities. The aim of this study was to evaluate the geographical proximity of MTFs to the continental US (CONUS) population and relative to existing civilian adult TCs, and then to determine which MTFs might benefit most from TC development.Methods Publicly available data were used to develop a list of CONUS adult civilian level 1 and level 2 TCs and also to generate a list of CONUS MTFs. Census data were used to estimate adult population densities across zip codes. Distances were calculated between zip codes and civilian TCs and MTFs. The affected population sizes and reductions in distance were tabulated for every zip code that was found to be closer to an MTF than an existing TC.Results 562 civilian adult level 1 and level 2 TCs and 33 military medical centers and hospitals were identified. Compared with their closest civilian TCs, MTFs showed mean reductions in distance ranging from 0 to 30 miles, affecting populations ranging from 12 000 to over 900 000 adults. Seven MTFs were identified that would offer clinically significant reductions in distance to relatively large population centers.Discussion Some MTFs may offer decreased transit times and improved care to large adult populations within their regional trauma systems by developing level 1 or level 2 TC capabilities. The results of this study provide recommendations to focus further study on seven MTFs to identify those that merit further development and integration with their local trauma systems.Level of evidence IV.https://tsaco.bmj.com/content/7/1/e000832.full
spellingShingle Stacy A Shackelford
Matthew D Tadlock
Blair C Lee
Christian S McEvoy
Dan Ross-Li
Emily A Norris
Shane D Jensen
Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
Trauma Surgery & Acute Care Open
title Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
title_full Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
title_fullStr Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
title_full_unstemmed Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
title_short Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
title_sort building trauma capability using geospatial analysis to consider military treatment facilities for trauma center development
url https://tsaco.bmj.com/content/7/1/e000832.full
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