Abstract
Motor vehicle accidents are one of the most prevalent causes of traumatic injury in patients needing transport to a trauma center. Arrival at a trauma center within an hour of the accident increases a patient’s chances of survival and recovery. However, not all vehicle accidents in Tennessee are accessible to a trauma center within an hour by ground transportation. This study uses the anti-covering location problem (ACLP) to assess the current placement of trauma centers and explore optimal placements based on the population distribution and spatial pattern of motor vehicle accidents in 2015 through 2019 in Tennessee. The ACLP models seek to offer a method of exploring feasible scenarios for locating trauma centers that intend to provide accessibility to patients in underserved areas who suffer trauma as a result of vehicle accidents. The proposed ACLP approach also seeks to adjust the locations of trauma centers to reduce areas with excessive service coverage while improving coverage for less accessible areas of demand. In this study, three models are prescribed for finding optimal locations for trauma centers: (a) TraCt: ACLP model with a geometric approach and weighted models of population, fatalities, and spatial fatality clusters of vehicle accidents; (b) TraCt-ESC: an extended ACLP model mitigating excessive service supply among trauma center candidates, while expanding services to less served areas for more beneficiaries using fewer facilities; and (c) TraCt-ESCr: another extended ACLP model exploring the optimal location of additional trauma centers.
Highlights
Geographical accessibility to health care facilities is essential to ensure safer and healthier lives
The percentage of demands covered by the overall areas of time distance constraint (TDC) was used in this analysis because it was intuitive to compare the beneficiaries according to different TDCs and model variations
46% of demands are covered within 30 min TDCs, but nearly 77% of the vehicle accidents and their fatalities are covered within 60 min TDCs from the trauma centers
Summary
Geographical accessibility to health care facilities is essential to ensure safer and healthier lives. The more convenient and the better the access to healthcare facilities, the more beneficial they are in meeting patients’ medical needs. Of concern in this research, trauma centers are specialized medical facilities designed to cope with unexpected accidents or illnesses requiring the most time-sensitive healthcare [1,2,3,4]. Emergency healthcare services (EMS) are time dependent. Many emergency care patients are in a life-or-death situation for which only timely assistance can increase the chance of survival and recovery. Trauma care is the most time-dependent service among. Certain locations are frequently sites of critical accidents or emergency medical situations, but the patients may not have access to vital services when they face a life-ordeath situation at a location far away from emergency healthcare facilities. Hashmi et al [6]
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