Emergency care regionalization

Hogan, Andrew N; Rosenberger, Reagan; Fowler, Raymond L.

doi:10.1002/9781119756279.ch72

Cited by 1 publication

(2 citation statements)

References 39 publications

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“…44,46,48,49,51 However, volume per se might not be the leading factor; several important factors include training, protocols, team expertise, benchmarking, maintaining a low threshold for asking for support. 51,53,68 Health systems focus primarily on improving the health of the population and may align resources to assist referring hospitals through regionalization, 45,[69][70][71][72][73][74][75][76][77] and might be better positioned to accomplish this, as efficiency can be increased by sharing resources and capabilities across facilities. 47,55,[78][79][80] The combination of high-volume ECLS center with an effective and appropriately located retrieval service may balance out certain local deficits.…”

Section: Discussionmentioning

confidence: 99%

“…47,55,[78][79][80] The combination of high-volume ECLS center with an effective and appropriately located retrieval service may balance out certain local deficits. 73 The geospatial analysis revealed substantial variation in spatial access to ECLS centers between countries. In general, the availability and allocation of ECLS-providing hospitals, the connectivity of road networks, and the distribution of the adult or pediatric population within each European country may contribute to the significant geographical differences in the accessibility of ECLS-providing hospitals.…”

Section: Discussionmentioning

confidence: 99%

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GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

et al. 2023

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Introduction A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. Methods Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. Results 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within 1 hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0–14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. Conclusions ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

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