title: A population-based, multivariate analysis of the association between 911 access and per-capita county trauma death rates.
abstract: OBJECTIVE
  Decreased response times for injury should decrease the morbidity and mortality of trauma. The 911 telephone access is designed to improve the response time for emergencies. The purpose of this study was to analyze the association between county 911 access and per-capita county trauma death rates.
  
  
  METHODS
  Data on all trauma deaths from 1986 through 1988 were obtained from the North Carolina Medical Examiner's data base. Counties were divided into those that had 911 access during the entire study period (15), those that never had 911 access (62), and those that installed 911 during 1987 (ten). Counties obtaining 911 access in 1986 or 1988 were excluded (13).
  
  
  RESULTS
  The per-capita trauma death rate in counties that had 911 access throughout the study was 4.3 +/- 0.8 versus 5.0 +/- 1.1 per 10,000 population in counties that never had 911 access (P less than .01). Compared with counties with 911 access, counties without 911 were more rural, were less likely to have a trauma center, and were less likely to have advanced life support certification (P less than .03 for all). Controlling for these other factors, multivariate analysis demonstrated that 911 access had no significant independent association with per-capita county trauma death rates. In the ten counties that implemented 911 access in 1987, no significant change occurred in per-capita county trauma death rates after implementation of 911.
  
  
  CONCLUSIONS
  Although counties with 911 access had lower trauma death rates by t-test, multivariate analysis showed no significant independent association of 911 access with per-capita county trauma death rates. In the ten counties that implemented 911 access in 1987, no significant changes in trauma death rates occurred after implementation. Although other factors may explain these findings, this study showed no significant independent impact of 911 access on per-capita county trauma death rates.
authors.affiliation: Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill.
authors.forename: T
authors.initials: T
authors.lastname: Patsey
authors.forename: J
authors.initials: J
authors.lastname: Messick
authors.forename: R
authors.initials: R
authors.lastname: Rutledge
authors.forename: A
authors.initials: A
authors.lastname: Meyer
authors.forename: J M
authors.initials: JM
authors.lastname: Butts
authors.forename: C
authors.initials: C
authors.lastname: Baker
mesh_terms: D004631:Emergency Medical Service Communication Systems; D006801:Humans; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000401:mortality*