title: Geographic disparities in access to urban trauma care: defining the problem and identifying a solution for gunshot wound victims in Chicago.
abstract: BACKGROUND
  Timely transport to designated trauma centers impacts mortality following serious injury. We examined whether the distribution of trauma centers in Chicago has created disparities in access to trauma care.
  
  
  METHODS
  Using the Illinois State Trauma Registry, locations of Chicago-area gunshot wounds (GSWs) from 1999 to 2009 were geocoded and transport times were analyzed for pediatric (age ≤ 15) and adult (age ≥ 16) GSWs.
  
  
  RESULTS
  A total of 11,744 included pediatric and adult GSWs were analyzed. Adults experienced longer mean transport times (11.3 vs 10.2 minutes, P < .001). Disproportionate numbers of adult GSW victims experienced over 30-minute transport times on Chicago's south side. Pediatric GSWs demonstrated no such disparity, likely attributable to the presence of a pediatric trauma center on the southeast side.
  
  
  CONCLUSIONS
  Geographic disparities in access to trauma care exist even within urban trauma systems. The absence of an adult trauma center on Chicago's southeast side has contributed to these disparities.
authors: Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 650, Chicago, IL 60611, USA.
authors: Michael
authors: M
authors: Wandling
authors: Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 650, Chicago, IL 60611, USA.
authors: Jess
authors: J
authors: Behrens
authors: Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA.
authors: Renee
authors: R
authors: Hsia
authors: Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 650, Chicago, IL 60611, USA. Electronic address: marie.crandall@jax.ufl.edu.
authors: Marie
authors: M
authors: Crandall
mesh_terms: D000293:Adolescent; D000328:Adult; D002641:Chicago / Q000453:epidemiology; D004632:Emergency Medical Services; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012042:Registries; D013997:Time Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014193:Trauma Centers; D019037:Urban Health Services; D014948:Wounds, Gunshot / Q000453:epidemiology*
keywords: Access; Disparities; Prehospital transport; Trauma systems