Location of trauma care resources with inter-facility patient transfers

Traumatic injury is the third leading cause of death in the United States and is the leading cause of death among people aged 1–44. Regional trauma care systems can significantly reduce this mortality rate if resources are located and used appropriately. Trauma centers are categorized as able to eit...

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Autores principales:	Eric DuBois, Adam Schmidt, Laura A. Albert
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Location analysis Emergency medicine Trauma care system Optimization Mathematics QA1-939
Acceso en línea:	https://doaj.org/article/d42f953f418945bd9a11eb1ec4978773
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spelling	oai:doaj.org-article:d42f953f418945bd9a11eb1ec49787732021-11-18T04:49:03ZLocation of trauma care resources with inter-facility patient transfers2214-716010.1016/j.orp.2021.100206https://doaj.org/article/d42f953f418945bd9a11eb1ec49787732021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214716021000233https://doaj.org/toc/2214-7160Traumatic injury is the third leading cause of death in the United States and is the leading cause of death among people aged 1–44. Regional trauma care systems can significantly reduce this mortality rate if resources are located and used appropriately. Trauma centers are categorized as able to either provide total care (Level I or II) or prompt care (Level III and IV). We study trauma system planning by introducing an integer programming model to optimally relocate existing air ambulances, locate new air ambulances, and upgrade Level III and IV trauma centers to Level I or II trauma centers within a mature trauma system. The goal of these models to improve timely access to care and ensure the appropriate level of care is provided to severely injured patients. A novel aspect of the modeling approach is the inclusion of patient transfers from Level III/IV trauma centers to Level I/II trauma centers. Patient transfers are of particular importance after mass casualty events when a surge of trauma patients can overwhelm local trauma center capacity. As a result, we introduce a mass casualty incident response stochastic programming model to optimally relocate air ambulances within the trauma system following a mass casualty incident but before patient demand is known with certainty. The two models inform planning decisions by considering the interrelated response decisions. We construct case studies for both models based on the Wisconsin, USA trauma care system. The results highlight the importance of relocating air ambulances for increasing the number of patients transported directly to a Level I/II trauma center. The results also indicate that considering patient transfers within the model can significantly alter the optimal locations of trauma care resources compared to when transfers are not considered.Eric DuBoisAdam SchmidtLaura A. AlbertElsevierarticleLocation analysisEmergency medicineTrauma care systemOptimizationMathematicsQA1-939ENOperations Research Perspectives, Vol 8, Iss , Pp 100206- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Location analysis Emergency medicine Trauma care system Optimization Mathematics QA1-939
spellingShingle	Location analysis Emergency medicine Trauma care system Optimization Mathematics QA1-939 Eric DuBois Adam Schmidt Laura A. Albert Location of trauma care resources with inter-facility patient transfers
description	Traumatic injury is the third leading cause of death in the United States and is the leading cause of death among people aged 1–44. Regional trauma care systems can significantly reduce this mortality rate if resources are located and used appropriately. Trauma centers are categorized as able to either provide total care (Level I or II) or prompt care (Level III and IV). We study trauma system planning by introducing an integer programming model to optimally relocate existing air ambulances, locate new air ambulances, and upgrade Level III and IV trauma centers to Level I or II trauma centers within a mature trauma system. The goal of these models to improve timely access to care and ensure the appropriate level of care is provided to severely injured patients. A novel aspect of the modeling approach is the inclusion of patient transfers from Level III/IV trauma centers to Level I/II trauma centers. Patient transfers are of particular importance after mass casualty events when a surge of trauma patients can overwhelm local trauma center capacity. As a result, we introduce a mass casualty incident response stochastic programming model to optimally relocate air ambulances within the trauma system following a mass casualty incident but before patient demand is known with certainty. The two models inform planning decisions by considering the interrelated response decisions. We construct case studies for both models based on the Wisconsin, USA trauma care system. The results highlight the importance of relocating air ambulances for increasing the number of patients transported directly to a Level I/II trauma center. The results also indicate that considering patient transfers within the model can significantly alter the optimal locations of trauma care resources compared to when transfers are not considered.
format	article
author	Eric DuBois Adam Schmidt Laura A. Albert
author_facet	Eric DuBois Adam Schmidt Laura A. Albert
author_sort	Eric DuBois
title	Location of trauma care resources with inter-facility patient transfers
title_short	Location of trauma care resources with inter-facility patient transfers
title_full	Location of trauma care resources with inter-facility patient transfers
title_fullStr	Location of trauma care resources with inter-facility patient transfers
title_full_unstemmed	Location of trauma care resources with inter-facility patient transfers
title_sort	location of trauma care resources with inter-facility patient transfers
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/d42f953f418945bd9a11eb1ec4978773
work_keys_str_mv	AT ericdubois locationoftraumacareresourceswithinterfacilitypatienttransfers AT adamschmidt locationoftraumacareresourceswithinterfacilitypatienttransfers AT lauraaalbert locationoftraumacareresourceswithinterfacilitypatienttransfers
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Location of trauma care resources with inter-facility patient transfers

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