An Exploratory Analysis of the Geographical Distribution of Trauma Incidents in Shenzhen, China

• Published in: World journal of surgery Vol. 41; no. 9; pp. 2207 - 2214
• Main Authors: Zhang, Gui Xi, Fan, Joe King Man, Chan, Fion Siu Yin, Leung, Gilberto Ka Kit, Lo, Chung Mao, Yu, Yi Min, Zhang, Hong, Brundage, Susan I., Jansen, Jan O.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2017; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Cardiac Surgery; China - epidemiology; Cluster Analysis; Clustering; Clusters; Communities; Community Health Planning; Community Hospital; Emergency Medical Service; Emergency medical services; Emergency Medical Services - statistics & numerical data; Female; General Surgery; Geographic Mapping; Geographical distribution; Health care; Health services; Hospitals, Community - utilization; Hospitals, Private - utilization; Hospitals, Teaching - utilization; Humans; Major Trauma; Male; Mapping; Medicine; Medicine & Public Health; Original Scientific Report; Patients; Regional Hospital; Retrospective Studies; Surgery; Thoracic Surgery; Trauma; Trauma Centers; Trauma Centre; Triage; Vascular Surgery; Wounds and Injuries - epidemiology; Young Adult; Major Trauma; Trauma Centre; Community Hospital; Regional Hospital; Emergency Medical Service
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-017-4002-y

Background The city of Shenzhen, China, is planning to establish a trauma system. At present, there are few data on the geographical distribution of incidents, which is key to deciding on the location of trauma centres. The aim of this study was to perform a geographical analysis in order to inform the development of a trauma system in Shenzhen. Methods Retrospective analysis of trauma incidents attended by Shenzhen Emergency Medical Services (EMS) in 2014. Data were obtained from Shenzhen EMS. Incident distribution was explored using dot and kernel density estimate maps. Clustering was determined using the nearest neighbour index. The type of healthcare facilities which patients were taken to was compared against patients’ needs, as assessed using the Field Triage Decision Scheme. Results There were 49,082 recorded incidents. A total of 3513 were classed as major trauma. Mapping demonstrates that incidents predominantly occurred in the western part of Shenzhen, with identifiable clusters. Nearest neighbour index was 0.048. Of patients deemed to have suffered major trauma, 8.5% were taken to a teaching hospital, 13.6% to a regional hospital, 42.6% to a community hospital, and 35.3% to a private hospital. The proportions of Step 1 or 2 negative patients were almost identical. Conclusion The majority of trauma patients, including trauma patients who are at greater likelihood of severe injury, are taken to regional and community hospitals. There are areas with identifiable concentrations of volume, which should be considered for the siting of high-level trauma centres, although further modelling is required to make firm recommendations.