PMID- 15749723
OWN - NLM
STAT- MEDLINE
DCOM- 20051020
LR  - 20181201
IS  - 1741-3842 (Print)
IS  - 1741-3842 (Linking)
VI  - 27
IP  - 2
DP  - 2005 Jun
TI  - Relationship between travel time to the nearest hospital and survival from 
      ruptured abdominal aortic aneurysms: record linkage study.
PG  - 165-70
AB  - BACKGROUND: There is currently a trend in Britain to concentrate specialist 
      services in a smaller number of hospitals in order to improve outcomes. However, 
      for rapidly life-threatening conditions such as ruptured abdominal aortic 
      aneurysms (RAAAs), the resulting increased travel time to hospital might 
      adversely affect survival. This study aimed to evaluate the relationship between 
      travel time to the nearest hospital and survival from RAAAs in West Sussex. 
      METHODS: Information was collected regarding outcome, postcode, age, sex and 
      diagnoses for all West Sussex residents who had a RAAA between January 1996 and 
      September 1999, including admissions and deaths, wherever they occurred. 
      Deprivation scores were calculated based on postcode. Potential travel time to 
      the nearest hospital was calculated using "Microsoft AutoRoute Express" and its 
      effect on outcome was analysed using multiple logistic regression. RESULTS: After 
      adjusting for age, sex, Townsend deprivation score and nearest hospital, the odds 
      ratio for survival associated with a 10 min increase in potential travel time to 
      the nearest hospital was 0.97 (0.88 unadjusted) (95 percent confidence interval 
      for adjusted odds ratio: 0.70 to 1.34; p = 0.86). CONCLUSION: Several previous 
      studies suggested better survival with longer distances travelled. They are 
      likely to be biased by omission of community deaths. This methodologically better 
      study found no such relationship between RAAA survival and travelling time to 
      hospital in West Sussex, although confidence intervals were wide. This is 
      particularly pertinent while there is a push to centralize vascular and other 
      services in the United Kingdom.
FAU - Souza, Veena C de
AU  - Souza VC
AD  - Department of Public Health Sciences, St George's Hospital Medical School, 
      Cranmer Terrace, London SW17 0RE, UK. vennaandjustin@hotmail.com
FAU - Strachan, David P
AU  - Strachan DP
LA  - eng
PT  - Journal Article
DEP - 20050304
PL  - England
TA  - J Public Health (Oxf)
JT  - Journal of public health (Oxford, England)
JID - 101188638
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aneurysm, Ruptured/*mortality
MH  - Aortic Aneurysm, Abdominal/*mortality
MH  - Bias
MH  - Confidence Intervals
MH  - England/epidemiology
MH  - Female
MH  - Health Services Accessibility/*statistics & numerical data
MH  - Hospital Mortality
MH  - Hospitals, Public/statistics & numerical data/*supply & distribution
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Meta-Analysis as Topic
MH  - Regional Health Planning
MH  - Rupture, Spontaneous
MH  - Specialties, Surgical/*organization & administration
MH  - State Medicine/*organization & administration
MH  - Survival Analysis
MH  - *Time
MH  - Time Factors
MH  - *Travel
EDAT- 2005/03/08 09:00
MHDA- 2005/10/21 09:00
CRDT- 2005/03/08 09:00
PHST- 2005/03/08 09:00 [pubmed]
PHST- 2005/10/21 09:00 [medline]
PHST- 2005/03/08 09:00 [entrez]
AID - fdi001 [pii]
AID - 10.1093/pubmed/fdi001 [doi]
PST - ppublish
SO  - J Public Health (Oxf). 2005 Jun;27(2):165-70. doi: 10.1093/pubmed/fdi001. Epub 
      2005 Mar 4.