title: Rural and urban distribution of trauma incidents in Scotland.
abstract: BACKGROUND
  Trauma systems reduce mortality and improve functional outcomes from injury. Regional trauma networks have been established in several European regions to address longstanding deficiencies in trauma care. A perception of the geography and population distribution as challenging has delayed the introduction of a trauma system in Scotland. The characteristics of trauma incidents attended by the Scottish Ambulance Service were analysed, to gain a better understanding of the geospatial characteristics of trauma in Scotland.
  
  
  METHODS
  Data on trauma incidents collected by the Scottish Ambulance Service between November 2008 and October 2010 were obtained. Incident location was analysed by health board region, rurality and social deprivation. The results are presented as number of patients, average annual incidence rates and relative risks.
  
  
  RESULTS
  Of the 141,668 incidents identified, 72·1 per cent occurred in urban regions. The risk of being involved in an incident was similar across the most populous regions, and decreased slightly with increasing rurality. Social deprivation was associated with greater numbers and risk. A total of 53·1 per cent of patients were taken to a large general hospital, and 38·6 per cent to a teaching hospital; the distribution was similar for the subset of incidents involving patients with physiological derangements.
  
  
  CONCLUSIONS
  The majority of trauma incidents in Scotland occur in urban and deprived areas. A regionalized system of trauma care appears plausible, although the precise configuration of such a system requires further study.
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK. jjmorrison@outlook.com
authors.forename: J J
authors.initials: JJ
authors.lastname: Morrison
authors.forename: N J
authors.initials: NJ
authors.lastname: McConnell
authors.forename: J A
authors.initials: JA
authors.lastname: Orman
authors.forename: G
authors.initials: G
authors.lastname: Egan
authors.forename: J O
authors.initials: JO
authors.lastname: Jansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*