title: Trauma center accessibility for road traffic injuries in Hanoi, Vietnam.
abstract: BACKGROUND
  Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts toward injury prevention have not produced a significant decline in the incidence of RTIs. Our study sought to describe the geographic distribution of RTIs in Hanoi, Vietnam and to evaluate the accessibility of trauma centers to those injured in the city.
  
  
  METHODS
  We performed a cross-sectional study using Hanoi city police reports from 2006 to describe the epidemiology of RTIs occurring in Hanoi city. Additionally, we identified geographic patterns and determined the direct distance from injury sites to trauma centers by applying geographical information system (GIS) software. Factors associated with the accessibility of trauma centers were evaluated by multivariate regression analysis.
  
  
  RESULTS
  We mapped 1,271 RTIs in Hanoi city. About 40% of RTIs occurred among people 20-29 years of age. Additionally, 63% of RTIs were motorcycle-associated incidents. Two peak times of injury occurrence were observed: 12 am-4 pm and 8 pm-0 am. "Hot spots" of road traffic injuries/fatalities were identified in the city area and on main highways using Kernel density estimation. Interestingly, RTIs occurring along the two north-south main roads were not within easy access of trauma centers. Further, fatal cases, gender and injury mechanism were significantly associated with the distance between injury location and trauma centers.
  
  
  CONCLUSIONS
  Geographical patterns of RTIs in Hanoi city differed by gender, time, and injury mechanism; such information may be useful for injury prevention. Specifically, RTIs occurring along the two north-south main roads have lower accessibility to trauma centers, thus an emergency medical service system should be established.
authors.affiliation: Kyushu University Hospital, Department of Emergency and Critical Care Center, Fukuoka, Japan. nagata.takashi@gmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagata
authors.forename: Ayako
authors.initials: A
authors.lastname: Takamori
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Kimura
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakahara