title: Motor vehicle crash-related mortality is associated with prehospital and hospital-based resource availability.
abstract: BACKGROUND
  To date, attempts to assess the relationship between motor vehicle collision (MVC)-related mortality and medical resources availability have largely been unsuccessful.
  
  
  METHODS
  Information regarding sociodemographic characteristics, prehospital resources, and hospital-based resources for each county (n = 67) in the state of Alabama was obtained. MVC-related mortality rates (deaths per 1,000 collisions) by county were calculated and compared according to prehospital and hospital-based resource availability within each county after correcting for sociodemographic factors.
  
  
  RESULTS
  Counties with 24-hour availability of a general surgeon, orthopedic surgeon, neurosurgeon, computed tomographic scanner, and operating room were shown to have decreased MVC-related mortality (relative risk [RR], 0.88). The same was true for those counties with hospitals classified as Level I-II (RR, 0.71) and Level III-IV (RR, 0.83) trauma centers compared with counties with no trauma centers.
  
  
  CONCLUSIONS
  Appropriate, readily available hospital-based resources are associated with lower MVC-related mortality rates. This information may be useful in trauma system planning and development.
authors.affiliation: Center for Injury Sciences and Department of Surgery, University of Alabama at Birmingham, 35294-0016, USA. sherry.melton@ccc.uab.edu
authors.forename: Sherry M
authors.initials: SM
authors.lastname: Melton
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: James H
authors.initials: JH
authors.lastname: Abernathy
authors.forename: Paul
authors.initials: P
authors.lastname: MacLennan
authors.forename: James M
authors.initials: JM
authors.lastname: Cross
authors.forename: Loring W
authors.initials: LW
authors.lastname: Rue
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data; D000407:Alabama; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D011159:Population Surveillance; D012424:Rural Population; D014505:Urban Population