Geographic Variation in Outcome Benefits of Helicopter Transport for XXXX in the United States: A Retrospective Cohort Study.

@entity1 @entity14200 @entity130
OBJECTIVE: Evaluate the effect of US geographic region on outcomes of @entity14200 ( @entity14200 ) for @entity130 . BACKGROUND: @entity14200 is an integral component of @entity130 systems. Evidence suggests that @entity14200 is associated with improved outcomes; however, no studies examine the impact of geographic variation on outcomes for @entity14200 . METHODS: Retrospective cohort study of @entity1 undergoing scene @entity14200 or ground transport in the National @entity130 Databank (2009-2012). Subjects were divided by US census region. @entity14200 and ground transport subjects were propensity-score matched based on prehospital physiology and injury severity. Conditional logistic regression was used to evaluate the effect of @entity14200 on survival and discharge to home in each region. Region-level characteristics were assessed as potential explanatory factors. RESULTS: A total of 193,629 pairs were matched. @entity14200 was associated with increased odds of survival and discharge to home; however, the magnitude of these effects varied significantly across regions (P<0.01). The South had the greatest survival benefit (odds ratio: 1.44; 95% confidence interval: 1.39-1.49, P<0.01) and the Northeast had the greatest discharge to home benefit (odds ratio: 1.29; 95% confidence interval: 1.18-1.41, P<0.01). A subset of region-level characteristics influenced the effect of @entity14200 on each outcome, including helicopter utilization, injury severity, @entity130 center and helicopter distribution, @entity130 center access, traffic congestion, and urbanicity (P<0.05). CONCLUSIONS: Geographic region impacts the benefits of @entity14200 in @entity130 . Variations in resource allocation partially account for outcome differences. Policy makers should consider regional factors to better assess and allocate resources within @entity130 systems to optimize the role of @entity14200 .
