Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type

Abstract

This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma Registry (VSTR) and Transport Accident Commission (TAC), we identified 1597 people who had sustained transport-related orthopaedic, brain, or spinal cord injuries between 2006 and 2016 that met the study inclusion criteria. The adjusted odds of GP service use for regional participants were 76% higher than for metropolitan participants in the orthopaedic and traumatic brain injury (TBI) groups. People with spinal cord injury (SCI) living in regional areas had 72% lower adjusted odds of accessing mental health, 76% lower adjusted odds of accessing OT services, and 82% lower adjusted odds of accessing physical therapies compared with people living in major cities. People with a TBI living in regional areas on average travelled significantly further to access all post-discharge health services compared with people with TBI in major cities. For visits to medical services, the median trip distance for regional participants was 76.61 km (95%CI: 16.01–132.21) for orthopaedic injuries, 104.05 km (95% CI: 51.55–182.78) for TBI, and 68.70 km (95%CI: 8.34–139.84) for SCI. Disparities in service use and distance travelled to health services exist between metropolitan Melbourne and regional Victoria following serious injury.

Exploring the Social Determinants of Health and Health Disparities in Traumatic Brain Injury: A Scoping Review

“…Medicare and Medicaid patients of all race categories had poorer outcomes than privately insured White patients [81]. People with TBI living in more rural areas traveled significantly further to access postdischarge health services and had decreased amounts of follow-up healthcare appointments [58]. Countries with a high incidence of TBI has disproportionately higher research publications compared to countries with lower TBI populations [65].…”

“…The citations for the studies included in this analysis can be found in the Reference section [34,36,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68].…”

Influence of Psychological Factors on Participation and Life Satisfaction in the Context of Travel and Tourism after Spinal Cord Injury

“…A major obstacle to participation for people with disabilities is their common perception of travel failures as being inevitable [15]. While studies have analyzed the inaccessible service and environmental barriers affecting the travel decisions of people with disability [16,17], constraint theory further suggests that unless their psychological inhibitors (i.e., hesitation or fear of failures) are resolved [18], they will not be in the position to experience objective environmental inhibitors (i.e., architectural barriers or lack of adapted transportation). In such cases, improving the objective physical travel settings will not necessarily trigger their travel motivation [19].…”