Grant: Operating Grant: Advancing Theoretical & Methodological Innovations in Hlth Res

The costs of injury in the province of Ontario are staggering. Injury is the leading cause of death among young people, and the fourth leading cause of death overall. Ontario's trauma centres play a crucial role in saving the lives of injured patients. Research has shown that if an injured patient is treated at a trauma centre, their chance of surviving is improved by 25%. Unfortunately, these centres are all located in urban areas, and many Ontarians live in areas far remote from these specialized hospitals. Almost half of the patients injured in Ontario are first transported to non-trauma hospitals, and only later transferred. The hours and minutes following injury are crucial, and transfer from a non-trauma hospital to a trauma centre can delay live-saving interventions. Ensuring that patient transfers are as efficient as possible is critical. Unfortunately, because patient transfers are frequent and involve many different hospitals and individuals, physicians and decision makers have not had the tools required to study current transfer strategies in a meaningful way. In this study, we will use a novel approach to examine the efficiency of transfer among Ontario's injured patients. Using a technique that allows us to integrate a large amount of patient and hospital-level data with detailed geographic information, we will be able to identify the best destination for injured patients presenting at any emergency department in the province. We will then be able to compare optimal transfer routes with those that are currently used, and identify gaps in care. By combining this information with data about physicians' knowledge, transportation resources and other factors, we will identify opportunities for improving the efficiency of transfer among injured patients in Ontario. Our research will help identify ways to improve trauma centre access in our region, and will potentially help decision makers improve the transfer process for all critically ill patients.