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Does County-Level Medical Centre Policy Influence the Health Outcomes of Patients with Trauma Transported by the Emergency Medical Service System? An Integrated Emergency Model in Rural China

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  • Dai Su

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Yingchun Chen

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Hongxia Gao

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Haomiao Li

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Jingjing Chang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Shihan Lei

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Di Jiang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Xiaomei Hu

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Min Tan

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Zhifang Chen

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

Abstract

This study aimed to assess the effect of the county-level medical centre policy on the health outcomes of trauma patients transported by emergency medical service (EMS) system in rural China. The methodology involved the use of electronic health records (EHRs, after 2016) of patients with trauma conditions such as head injury ( n = 1931), chest (back) injury ( n = 466), abdominal (waist) injury ( n = 536), and limb injury ( n = 857) who were transported by EMS to the county-level trauma centres of Huining County and Huan County in Gansu, China. Each patient was matched with a counterpart to a county-level trauma centre hospital by propensity score matching. Cox proportional hazard models were used to estimate the hazard ratios (HRs) of such patients in different hospitals. The HRs of all patients with the abovementioned traumatic conditions transported by EMS to county-level trauma centre hospitals were consistently higher than those transported by EMS to traditional hospitals after adjusting for numerous potential confounders. Higher HRs were associated with all patients with trauma (HR = 1.249, p < 0.001), head injury (HR = 1.416, p < 0.001), chest (back) injury (HR = 1.112, p = 0.560), abdominal (waist) injury (HR = 1.273, p = 0.016), and limb injury (HR = 1.078, p = 0.561) transported by EMS to the county-level trauma centre hospitals. Our study suggests that the construction of county-level medical centre provides an effective strategy to improve the health outcomes of EMS-transported trauma patients in Gansu, China. Policy makers can learn from the experience and improve the health outcomes of such patients through a personalised trauma treatment system and by categorizing the regional trauma centre.

Suggested Citation

  • Dai Su & Yingchun Chen & Hongxia Gao & Haomiao Li & Jingjing Chang & Shihan Lei & Di Jiang & Xiaomei Hu & Min Tan & Zhifang Chen, 2019. "Does County-Level Medical Centre Policy Influence the Health Outcomes of Patients with Trauma Transported by the Emergency Medical Service System? An Integrated Emergency Model in Rural China," IJERPH, MDPI, vol. 16(1), pages 1-16, January.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:1:p:133-:d:195232
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    References listed on IDEAS

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