Trauma center accessibility for road traffic injuries in Hanoi, Vietnam
1 Kyushu University Hospital, Department of Emergency and Critical Care Center, Fukuoka, Japan
2 Kurume University Graduate School of Medicine, Kurume, Japan
3 Osaka City University, Graduate School of Literature and Human Science, Osaka, Japan
4 National Center for Global Health and Medicine, Department of emergency medicine and critical care, Tokyo, Japan
5 St. Marianna University School of Medicine, Department of Preventive Medicine, Kawasaki, Japan
Journal of Trauma Management & Outcomes 2011, 5:11 doi:10.1186/1752-2897-5-11Published: 30 September 2011
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.
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.
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.
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.