Imbalance of demand and supply for regionalized injury services: a case study in Greece.
OBJECTIVE
To study regionalized acute injury services on an island with high seasonal fluctuation of the population at risk.


METHODS
Of 9432 individuals with traumatic injuries who contacted the hospital during 1996, 1204 were hospitalized. Information was recorded on several injury-related clinical and sociodemographic variables. Possible residual disabilities, 6 months after the injury, were also assessed.


METHODS
Injury Severity Score (ISS), clinical outcome and duration of hospitalization, odds of transfer to other institutions.


RESULTS
Non-residents, whether Greek or foreign nationals are hospitalized for shorter periods. Motor vehicle accident victims are hospitalized on average for 15% longer. Injury victims admitted on a Friday are hospitalized for a longer period. Finally, ISS is a powerful positive predictor of duration of hospitalization. Male injury victims, those injured during late night or early morning and patients injured in July are more likely to be transferred to another institution. Age of the patient and ISS are powerful and independent predictors of an unfavourable outcome.


CONCLUSIONS
The extra demand created by injured tourists is reflected in the seasonality of admissions for injuries. The district hospital of Kerkyra cannot be considered as deficient in comparison to other district hospitals. Nevertheless, the suboptimal function of the hospital, with respect to injuries, is reflected in the high proportion of injured patients transferred when the injury occurs outside the full working schedule of the hospital. Patients with burns, bone fractures or dislocations and head injuries or concussion are transferred with an overall frequency of about 15%--too high to be compatible with a well functioning secondary care institution.
Petridou
E
E
Center for Research and Prevention of Injuries, Department of Hygiene and Epidemiology, Athens University, Greece. epetrid@atlas.uoa.gr
Gatsoulis
N
N
Dessypris
N
N
Skalkidis
Y
Y
Voros
D
D
Papadimitriou
Y
Y
Trichopoulos
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012041:Regional Medical Programs / Q000706:statistics & numerical data*; D012621:Seasons; D014195:Travel; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*