Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun;8(2):172-8.
doi: 10.1007/s11552-013-9503-z.

Tennessee emergency hand care distributions and disparities: Emergent hand care disparities

Joshua R Anthony  1 , Victoria N Poole  2 , Kevin W Sexton  3 , Li Wang  4 , Melissa A Mueller  5 , Oscar Guillamondegui  6 , R Bruce Shack  3 , Wesley P Thayer  3
Affiliations

Tennessee emergency hand care distributions and disparities: Emergent hand care disparities

Joshua R Anthony et al. Hand (N Y). 2013 Jun.

Abstract

Background: Hand trauma is the most frequently treated injury in emergency departments, but presently there is a crisis of insufficient emergency coverage. This study evaluates the discrepancy of emergent and elective hand care trends based on socioeconomic factors in the state of Tennessee.

Methods: We identified 119 hospitals in Tennessee that contained operating and emergency room facilities. Of these, 111 hospitals participated in a survey to determine the availability of elective and emergency hand surgery. Wilcoxon rank-sum test or permutation chi-square test and logistic regression were used to analyze reported measures.

Results: Our results revealed that hospitals in counties with the lowest per capita income and median household income are less likely to have hand specialists or offer hand call. There are also significantly fewer hospitals that have hand specialists and offer hand call that are located in medically underserved areas. In the state of TN, level 1 trauma facilities are required by the Tennessee Department of Health to have staffed hand specialists and 24/7 hand call. Our study revealed that while 7/8 (87.5 %) level 1 trauma facilities have hand specialists, only 2/8 (25 %) provide 24/7 hand specialist call.

Conclusion: Our results strongly suggest the presence of a health care disparity for hand trauma in counties with a low income and in medically underserved areas.

Keywords: Disparities; Disparity; Distributions; EMTALA; Elective; Emergency; Hand call; Hand specialist; Hand surgeon; Hand surgery; Income; Medically underserved area; Metropolitan; Rural; Tennessee; Trauma.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Plot of median household versus per capita income stratified by hand specialists and hand call
See this image and copyright information in PMC

References

    1. American Association of Medical Colleges. 2012. Available at https://www.aamc.org/. Accessed 4 Aug 2012.
    1. American College of Emergency Physicians. On-Call Specialist Coverage in U.S. Emergency Departments. April 2006. Available at http://www.acep.org/pressroom.aspx?id=25262&ekmensel=c580fa7b_92_134_252.... Accessed 16 Aug 2012.
    1. American Hospital Directory. 2012. Available at http://www.ahd.com/. Accessed 4 Aug 2012.
    1. American Society for Surgery of the Hand. 2012. Available at http://www.assh.org/Public/About/Pages/Why.aspx. Accessed 23 Dec 2012.
    1. Bureau of Labor Statistics. In: Nonfatal occupational injuries and illnesses requiring days away from work. 2010. http://www.bls.gov/news.release/osh2.nr0.htm. Accessed 5 Sept 2012.

LinkOut - more resources