Access to Neurosurgical Care for Traumatic Brain Injury in Ontario

• Main Author: Sharma, Sunjay
• Other Authors: Nathens, Avery B.
• Language: en_ca
• Published: 2013
• Subjects: trauma; brain injury; access; neurosurgery; TBI; undertriage; 0766; 0564; 0573
• Online Access: http://hdl.handle.net/1807/35686

Introduction: Trauma centers (TC) are the only institutions with resources to manage patients with severe traumatic brain injury (TBI). We chose to examine potential barriers to access to TC care for TBI patients. Methods: Administrative datasets were used to evaluate access to TC among patients with severe TBI. We examined triage practices of EMS in TBI. Finally, we analyzed surveys to capture the beliefs, perceptions and knowledge of ED physicians with respect to TBI. Results: 57% of patients in Ontario had any access to a TC following TBI. Of patients who had potential access to a TC from the scene of injury as defined by pre-hospital triage guidelines, 60% of patients were undertriaged. Challenges that ED physicians faced with managing TBI, included lack of beds at TC and difficulty attaining transport resources. Conclusion: Access to TC care for patients with TBI is impeded by patient and system level factors.