The prehospital time impact on traffic injury from hospital fatality and inpatient recovery perspectives

Abstract

A solid emergency medical service response is important to saving lives. Most past studies are however focused on the effect of response time on fatalities resulting from cardiac arrest and fewer from traffic crash. The present study aims to present an extensive analysis of the impact of prehospital time on traffic injuries covering two perspectives: hospital fatalities and victims recovery. The former is described by the probability of death, and the second is measured by two proxy variables named “length of hospital stay” (LHS) and “health care costs” (HCC). A binary model was used to analyze the probability of death and generalized linear models were applied separately to the LHS and HCC continuous variables. The random-parameter approach was considered. A linked data set, resulting from a linkage process between hospital and police data sets, was used. The results showed that the effect of prehospital time varies across observations and is positively correlated to LHS and HCC. Control variables such as age and sex of the victim, type of crash, hospital and injury severity classified by maximum abbreviated injury scale showed impact on the probability of death and on the inpatient recovery. The study results suggest the importance of actions to improve emergency service.

Keywords:

• injury severity
• health care costs
• length of hospital stay
• prehospital time
• traffic crash

Acknowledgment

The authors would like to thank to the European Commission, which co-funded this study through the project [project LIVE and Grant Agreement No.: MOVE/C4/SUB/2011-294/SI2.625804], and also to the institutions which granted the access to the information required by the study, namely, the Autoridade Nacional de Segurança Rodoviária, the Instituto Nacional de Emerg≖ncia Médica, the Centro Hospitalar de São João, the Centro Hospitalar do Porto, and the Centro Hospitalar de Vila Nova de Gaia/Espinho.