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. 2022 Oct 28;19(21):14063.
doi: 10.3390/ijerph192114063.

Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type

Jemma Keeves  1   2 , Belinda Gabbe  2 , Sarah Arnup  2 , Christina Ekegren  3 , Ben Beck  2
Affiliations

Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type

Jemma Keeves et al. Int J Environ Res Public Health. .

Abstract

This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma Registry (VSTR) and Transport Accident Commission (TAC), we identified 1597 people who had sustained transport-related orthopaedic, brain, or spinal cord injuries between 2006 and 2016 that met the study inclusion criteria. The adjusted odds of GP service use for regional participants were 76% higher than for metropolitan participants in the orthopaedic and traumatic brain injury (TBI) groups. People with spinal cord injury (SCI) living in regional areas had 72% lower adjusted odds of accessing mental health, 76% lower adjusted odds of accessing OT services, and 82% lower adjusted odds of accessing physical therapies compared with people living in major cities. People with a TBI living in regional areas on average travelled significantly further to access all post-discharge health services compared with people with TBI in major cities. For visits to medical services, the median trip distance for regional participants was 76.61 km (95%CI: 16.01-132.21) for orthopaedic injuries, 104.05 km (95% CI: 51.55-182.78) for TBI, and 68.70 km (95%CI: 8.34-139.84) for SCI. Disparities in service use and distance travelled to health services exist between metropolitan Melbourne and regional Victoria following serious injury.

Keywords: access to healthcare; geography; healthcare utilisation; orthopaedic injury; road trauma; serious injury; spinal cord injury; traumatic brain injury.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow diagram of inclusion criteria.
Figure 2
Figure 2
Boundaries for major cities (Greater Melbourne), dark grey, and regional. Victoria, light grey.
Figure 3
Figure 3
Summary of key findings for regional participants compared with participants in major cities.
Figure 4
Figure 4
Adjusted proportion of service use by injury group and region.
Figure 5
Figure 5
Adjusted number of trips to services in the first three years post-discharge by service type and injury group.
Figure 6
Figure 6
Ratio of geometric means for distance travelled by people in regional areas compared with major cities by injury group and service type.
Figure 7
Figure 7
Median and IQR of raw distances travelled to healthcare by service type and injury group.
See this image and copyright information in PMC

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