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Tennessee emergency hand care distributions and disparities

Emergent hand care disparities

  • AAHS Meeting Article
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HAND

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.

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Acknowledgments

This work was supported by an institutional grant from Meharry Medical College and an institutional grant (VICTR) from Vanderbilt University Medical Center.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. School of Medicine, Meharry Medical College, 1005 Doctor D.B. Todd Junior Boulevard, Nashville, TN, 37208, USA

    Joshua R. Anthony

  2. Department of Plastic Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA

    Joshua R. Anthony, Kevin W. Sexton, Melissa A. Mueller, R. Bruce Shack & Wesley P. Thayer

  3. Weldon School of Biomedical Engineering, Purdue University, 206 Martin Jischke Drive, West Lafayette, IN, 47907, USA

    Victoria N. Poole

  4. Department of Biostatistics, Vanderbilt University School of Medicine, 2323 Medical Center North, Nashville, TN, 37232-2158, USA

    Li Wang

  5. School of Medicine, Vanderbilt University, 1161 21st Ave S # D3300, Nashville, TN, 37232, USA

    Melissa A. Mueller

  6. Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA

    Oscar Guillamondegui

Authors
  1. Joshua R. Anthony
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  2. Victoria N. Poole
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  3. Kevin W. Sexton
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  4. Li Wang
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  5. Melissa A. Mueller
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  6. Oscar Guillamondegui
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  7. R. Bruce Shack
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  8. Wesley P. Thayer
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Corresponding author

Correspondence to Wesley P. Thayer.

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Cite this article

Anthony, J.R., Poole, V.N., Sexton, K.W. et al. Tennessee emergency hand care distributions and disparities. HAND 8, 172–178 (2013). https://doi.org/10.1007/s11552-013-9503-z

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  • DOI: https://doi.org/10.1007/s11552-013-9503-z

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