Toward an outcome-oriented medical geography: An evaluation of the Illinois Trauma/Emergency Medical Services System

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Abstract

Research in health services by geographers has failed to address important questions related to the quality of medical care. The reduction of distance traveled to hospitals or physicians has been emphasized without sufficient attention to patient outcomes. An evaluation of the Illinois Trauma/Emergency Medical Services System (in the Southern-most region of the state) is presented as an exemplar of outcome-oriented medical geography. A sample of vehicular injuries and deaths are compared for a four-year study period: two years prior to system implementation (Fiscal Years 1970–1971) and two years after system initiation (Fiscal Years 1972–1973). This analysis reveals three programmatic failures: (a) there was no increase in the number of critically injured vehicular trauma victims treated at trauma centers; (b) distances that patients traveled to care remained relatively constant after system implementation; (c) the size of hospital service area did not conform to program guidelines. Yet, the Illinois Trauma/Emergency Medical Services System is judged a success because of decreases in mortality rates which are experienced at trauma hospitals in Fiscal Years 1972–1973; mortality rates at those hospitals which did not become trauma centers remained constant.

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This study was supported in part by Grant No. 1 RO1-HS 01957-01 awarded by the National Center for Health Services Research.

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