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

Int J Environ Res Public Health. 2022 Oct 28;19(21):14063. doi: 10.3390/ijerph192114063.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aftercare
  • Brain Injuries, Traumatic* / epidemiology
  • Brain Injuries, Traumatic* / therapy
  • Humans
  • Patient Discharge
  • Registries
  • Spinal Cord Injuries* / epidemiology
  • Spinal Cord Injuries* / therapy

Grants and funding

This research was funded in part by an Epworth Medical Foundation, Translational Research Grant. JK was supported by an Australian Government Research Training Program Scholarship. CE was supported by a National Health and Medical Research Council of Australia (NHMRC) Early Career Fellowship (1106633). BG was supported by an Australian Research Council Future Fellowship (FT170100048). BB was supported by an Australian Research Council Discovery Early Career Researcher Award Fellowship (DE180100825).