Googling Service Boundaries for Endovascular Clot Retrieval Hub Hospitals in a Metropolitan Setting: Proof-of-Concept Study

Thanh G Phan; Richard Beare; Jian Chen; Benjamin Clissold; John Ly; Shaloo Singhal; Henry Ma; Velandai Srikanth

doi:10.1161/STROKEAHA.116.015323

Googling Service Boundaries for Endovascular Clot Retrieval Hub Hospitals in a Metropolitan Setting: Proof-of-Concept Study

Stroke. 2017 May;48(5):1353-1361. doi: 10.1161/STROKEAHA.116.015323. Epub 2017 Mar 29.

Authors

Thanh G Phan¹, Richard Beare², Jian Chen², Benjamin Clissold², John Ly², Shaloo Singhal², Henry Ma², Velandai Srikanth²

Affiliations

¹ From the Stroke Unit, Monash Health, Melbourne, Victoria, Australia (T.G.P., B.C., J.L., S.S., H.M., V.S.); Stroke and Aging Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia (T.G.P., R.B., J.C., B.C., J.L., S.S., H.M., V.S.); Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia (R.B., V.S.); Central Clinical School, Monash University, Melbourne, Victoria, Australia (R.B., V.S.); and Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia (R.B., J.C.). phantg@hotmail.com.
² From the Stroke Unit, Monash Health, Melbourne, Victoria, Australia (T.G.P., B.C., J.L., S.S., H.M., V.S.); Stroke and Aging Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia (T.G.P., R.B., J.C., B.C., J.L., S.S., H.M., V.S.); Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia (R.B., V.S.); Central Clinical School, Monash University, Melbourne, Victoria, Australia (R.B., V.S.); and Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia (R.B., J.C.).

PMID: 28356438
DOI: 10.1161/STROKEAHA.116.015323

Abstract

Background and purpose: There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub.

Methods: Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface. Boundary maps generated based on traveling time at various times of day for combinations of hubs.

Results: In a 2-hub model, catchment was best distributed when RMH was paired with MMC (model 1a, RMH 1765 km² and MMC 1164 km²) or with AUS (model 1c, RMH 1244 km² and AUS 1685 km²), with no statistical difference between models (P=0.20). Catchment was poorly distributed when RMH was paired with ALF (model 1b, RMH 2252 km² and ALF 676 km²), significantly different from both models 1a and 1c (both P<0.05). Model 1a had the greatest proportion of patients arriving within ideal time of 30 minutes followed by model 1c (P<0.001). In a 3-hub model, the combination of RMH, MMC, and AUS was superior to that of RMH, MMC, and ALF in catchment distribution and travel time. The method was also successfully applied to the city of Adelaide demonstrating wider applicability.

Conclusions: We provide proof of concept for a novel computational method to objectively designate service boundaries for endovascular clot retrieval hubs.

Keywords: Google; endovascular treatment; hospital; mapping.

MeSH terms

Catchment Area, Health / statistics & numerical data*
Endovascular Procedures / standards
Endovascular Procedures / statistics & numerical data*
Hospitals / statistics & numerical data*
Humans
Internet*
Models, Statistical
Spatial Analysis*
Stroke / therapy*
Transportation of Patients / standards
Transportation of Patients / statistics & numerical data*
Victoria