Geographic access to burn center hospitals.
BACKGROUND
The delivery of burn care is a resource-intensive endeavor that requires specialized personnel and equipment. The optimal geographic distribution of burn centers has long been debated; however, the current distribution of centers relative to geographic area and population is unknown.


OBJECTIVE
To estimate the proportion of the US population living within 1 and 2 hours by rotary air transport (helicopter) or ground transport of a burn care facility.


METHODS
A cross-sectional analysis of geographic access to US burn centers utilizing the 2000 US census, road and speed limit data, the Atlas and Database of Air Medical Services database, and the 2008 American Burn Association Directory.


METHODS
The proportion of state, regional, and national population living within 1 and 2 hours by air transport or ground transport of a burn care facility.


RESULTS
In 2008, there were 128 self-reported burn centers in the United States including 51 American Burn Association-verified centers. An estimated 25.1% and 46.3% of the US population live within 1 and 2 hours by ground transport, respectively, of a verified burn center. By air, 53.9% and 79.0% of the population live within 1 and 2 hours, respectively, of a verified center. There was significant regional variation in access to verified burn centers by both ground and rotary air transport. The greatest proportion of the population with access was highest in the northeast region and lowest in the southern United States.


CONCLUSIONS
Nearly 80% of the US population lives within 2 hours by ground or rotary air transport of a verified burn center; however, there is both state and regional variation in geographic access to these centers.
Klein
Matthew B
MB
UW Burn Center, University of Washington, Seattle, WA 98104, USA. mbklein@u.washington.edu
Kramer
C Bradley
CB
Nelson
Jason
J
Rivara
Frederick P
FP
Gibran
Nicole S
NS
Concannon
Thomas
T
D017732:Air Ambulances; D002053:Burn Units / Q000600:supply & distribution*; D002056:Burns / Q000628:therapy*; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility; D006801:Humans; D040841:Resource Allocation; D014187:Transportation of Patients; D014481:United States