Grant: CIHR Fellowship

The personal and economic costs of injury in the province of Ontario are staggering. Each year, over 500,000 people are injured. Almost one quarter of these patients are hospitalized, and 11 patients die each day. The total cost of injury in the province amounts to more than $5.7 billion. It is the leading cause of death among young people, and the fourth leading cause of death overall. Ontario's 11 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 20%.Unfortunately, these centres are all located in urban areas, and many Ontarians live in areas far remote from these specialized hospitals. In fact, 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 to survival, and transfer from a non-trauma hospital to a trauma centre can delay live-saving interventions by many hours. These delays cost lives - some patients even die before they can be transferred. Surprisingly, physicians and decision-makers currently know very little about the causes of these delays, or how to prevent them. Clearly, access to trauma care in rural regions must become an urgent research priority. In this project, we will study Ontario's trauma system to understand how our current transfer network functions, which will allow us to identify the causes of transfer delays, and to study their impact on patients. This study is unique because, along with traditional analyses of large databases, it incorporates the experience and viewpoint of rural trauma providers directly into study recommendations. Our findings will identify opportunities for system improvement, and have the potential to dramatically reduce injury-related mortality for patients in the most vulnerable regions of this province.