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Linking Dispatch, Paramedic, Hospital, and Regional Planning Data in Portland, Oregon: Christopher Bangs, MS Department of Emergency Medicine, Oregon.

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Presentation on theme: "Linking Dispatch, Paramedic, Hospital, and Regional Planning Data in Portland, Oregon: Christopher Bangs, MS Department of Emergency Medicine, Oregon."— Presentation transcript:

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2 Linking Dispatch, Paramedic, Hospital, and Regional Planning Data in Portland, Oregon: Christopher Bangs, MS Department of Emergency Medicine, Oregon Health & Science University Portland, Oregon Geospatial Analysis of Traffic-Related Injury Data

3 The Annual Toll of Traffic-Related Injury in the USA and Oregon  On an average, each year in the USA Millions are injured in motor vehicle crashes. 42,000 persons die.  On an average, each year in Oregon There are 5,000+ hospitalizations for motor vehicle trauma persons die. (sources: NHTSA, NSC, CDC, ODOT, Oregon EMS, Oregon Trauma Registry)

4  We propose to link non-traditional data sources with traffic-related injury data to provide an improved understanding of the causes, consequences, and social implications of injury as a public health problem in the Portland, Oregon metropolitan region.  We developed a geocoded dataset to link these datasets, and provide a foundation for spatial analysis. Scope of the project:

5 Primary Data Source (TCC):  TCC staff verify injury incident location by contacting either paramedic or Bureau of Emergency Communications during the same shift, and are trained in geocoding methods.  Geocoding began on April 1,  Address match rate = ~95% with manual correction, using the Oregon Trauma Band Number (placed on patient in the field). Area Trauma communications center - regional trauma system data

6 Primary Data Source (METRO RLIS):  Metro regional government is a directly-elected regional authority serving the Portland tri-county region.  Similar to metropolitan planning organization.  Maps include street networks, county, flood plain maps, traffic analysis zones, planning zones, and USGS topographic maps, geocoded and current for the region. Metropolitan regional land use information systems data

7 Other Data Sources  Multnomah County EMS trauma data (subset of Oregon Trauma Registry)  Portland police neighborhood crime data [CRIME]  Oregon and OHSU Trauma Registries  Hospital emergency department information system

8 Methods  Retrospective, population & incidence studies with spatiotemporal analyses  OHSU houses the TCC data repository.  TCC staff require the assignment of trauma band number by the prehospital provider if they are missing or duplicated by first responders in the field.

9 Methods  Focused population of interest, with goal to link related but previously unlinked data sets.  TCC data are the primary source of injury data for the analysis (points).  METRO Regional Land Information System provides base mapping information for area of study - aggregate data by neighborhood, TAZs (polygons).  CRIME data was aggregated on neighborhood samples.

10 Trauma Band Number Pre-Hospital Chart Trauma Communications Record EDIS / Hospital Charts OTR 911 Dispatch Data Neighborhood Crime Data

11 Area of Study: Portland, Oregon metropolitan area Regional Trauma System Map 1

12 Findings: All Traumas ( ) Map 2

13 Map 3

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15 Limitations of Linking Datasets  Common trauma registry limitations - missing data, retrospective data, addresses are incomplete/incorrect.  Descriptive maps based upon both points and aggregations.  Crime data were incomplete, so sampling was required.  Agencies use different operational and field definitions for data points and variables.

16 Strengths and Unique Considerations  The Oregon trauma band number links disparate datasets  METRO RLIS neighborhood base maps  EMS data repository for dispatch, trauma, cardiac and hospital outcome data  Census, police, planning, and other Oregon agency databases are embracing GIScience  OHSU houses national ED electronic surveillance projects (CDC EMERGE ID NET)

17 Linking medical databases for optimal patient care and population studies – potentialities  “The Australian government…is creating a Master Person Index to allow its socialized health care system to identify and access the medical records of any citizen brought to a hospital for treatment. This is not a single monolithic database but rather the creation of an index that involves linking and integrating the many hospital-patient databases…”  Ephraim Schwartz in INFOWorld Sept. 24, 2001

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19 Conclusions  Accurate and precise base maps are critical.  Creation of a common link in the identifier dataset is critical to linking both traditional and non-traditional databases.  Spatial data do not correlate with medical outcome data; a linking mechanism is required.  Disparate datasets can communicate and enhance our understanding of the injury problem.  Collaboration among organizations provides opportunity to expand knowledge and extend resources to study public health issues.

20 Research is Promising: The Now and Future  Spatiotemporal variations in traffic injury  Spatiotemporial aspects of EMS services, based on trauma activity  Proximity of injury to destinations, types of businesses, parks, etc.  Oregon trauma band number utilization and outcome data  EMS injury surveillance system, linking traffic injury, SES, planning, social and crime data


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