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Article

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

by 1,2, 1,2,*, 1,2, 1,2, 1,2, 1,2, 1,2, 1,2, 1,2 and 1,2
1
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
2
Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(1), 133; https://doi.org/10.3390/ijerph16010133
Received: 4 December 2018 / Revised: 27 December 2018 / Accepted: 2 January 2019 / Published: 6 January 2019
(This article belongs to the Special Issue Rural Health Disparities)
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. View Full-Text
Keywords: county-level medical centre; health outcomes; patients with trauma transported by EMS; propensity score matching; Cox proportional hazard model county-level medical centre; health outcomes; patients with trauma transported by EMS; propensity score matching; Cox proportional hazard model
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MDPI and ACS Style

Su, D.; Chen, Y.; Gao, H.; Li, H.; Chang, J.; Lei, S.; Jiang, D.; Hu, X.; Tan, M.; Chen, Z. 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. Int. J. Environ. Res. Public Health 2019, 16, 133. https://doi.org/10.3390/ijerph16010133

AMA Style

Su D, Chen Y, Gao H, Li H, Chang J, Lei S, Jiang D, Hu X, Tan M, Chen Z. 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. International Journal of Environmental Research and Public Health. 2019; 16(1):133. https://doi.org/10.3390/ijerph16010133

Chicago/Turabian Style

Su, Dai; Chen, Yingchun; Gao, Hongxia; Li, Haomiao; Chang, Jingjing; Lei, Shihan; Jiang, Di; Hu, Xiaomei; Tan, Min; Chen, Zhifang. 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" Int. J. Environ. Res. Public Health 16, no. 1: 133. https://doi.org/10.3390/ijerph16010133

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