TitleThe Impact of Distance to Treatment Center on Long-Term Outcomes of Burn Patients.
Publication TypeJournal Article
Year of Publication2022
AuthorsGalicia KE, Mehta A, Riviello R, Nitzschke S, Bamer A, Gibran NS, Stewart BT, Wolf SE, Ryan CM, Kubasiak J, Schneider JC
JournalJ Burn Care Res
Date Published2022 Aug 08
ISSN1559-0488
Abstract

Geospatial proximity to American Burn Association (ABA)-verified burn centers or self-designated burn care facilities varies across the country. This study evaluates the impact of distance to treatment center on long-term, patient-reported outcomes. Data from the Burn Model System (BMS) National Longitudinal Database were analyzed. Demographic and clinical data were compared between three cohorts stratified by distance to BMS center (<20, 20-49.9, >50 miles). Distance to BMS center was calculated as driving distance between discharge and BMS center ZIP code centroids. The following patient-reported outcomes, collected at 12-months follow-up, were examined: Veterans RAND 12-Item Health Survey (VR-12), Satisfaction with Life (SWL) scale, employment status, and days to return to work. Mixed model regression analyses were used to examine the associations between distance to BMS center and each outcome, controlling for demographic and clinical variables. Of 726 patients included in this study, 26.3% and 28.1% were <20 and between 20-49.9 miles to a BMS center, respectively; 46.6% were >50 miles to a BMS center. Greater distance was associated with white/non-Hispanic race/ethnicity, pre-injury employment, flame injury, and larger burn size (p<0.001). Regression analyses did not identify significant associations between distance to BMS center and any patient-reported outcomes. This study suggests that patients treated at BMS centers have similar long-term, patient-reported outcomes of physical and psychosocial function, as well as employment, despite centralization of burn care and rehabilitation services. Given a steady decline in the incidence of burn injury, continued concentration of key resources is logical and safe.

DOI10.1093/jbcr/irac112
Alternate JournalJ Burn Care Res
PubMed ID35939346