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Seriously injured patients in rural areas less likely to be treated at major trauma centers

American Medical Response paramedic Shane Moore brings a patient into the emergency department at Oregon Health & Science University, October 11, 2016. (OHSU/Kristyna Wentz-Graff)


Only 29 percent of patients who live rural areas and require critical interventions following trauma are directly transported to a major trauma center, while nearly 89 percent of patients living in urban areas are.


New research conducted at the OHSU Center for Policy and Research in Emergency Medicine uncovered disparities in timely access to emergency trauma care in rural versus urban communities. The study published online today in JAMA Surgery.

Based on a review of more than 40 emergency medical services agencies across Oregon and Washington, the research team, led by Craig Newgard, M.D., M.P.H., also found:

  • While the overall mortality rate did not differ between rural and urban regions, a larger population of rural deaths occurred shortly after injury. (rural: 90 percent; urban: 64 percent).
  • Rural versus urban EMS providers were similarly able to identify patients requiring early critical care resources, yet only 40 percent of patients in rural areas ultimately reached a major trauma center (versus 89 percent in urban areas).

Additional research is needed to determine the exact causes of these variances; however, the researchers speculated the disparities may result from differences in EMS systems, access to major trauma care, severity of injury and patient preference.

This research was funded by the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (#R01CE01837).


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