307586
Geographical analysis of functional health outcomes after pediatric injury using a spatial scan statistic
Monitoring health outcomes following injury is important for planning interventions. Targeting interventions by geography may help ensure that resources are allocated to those in need. The purpose of this study was to apply a spatial scan statistic for identifying geographic clusters of injury survivors reporting similar health outcomes after injury.
Methods
Injured children (ages ≤16, n = 288) were recruited from the emergency department and in-patient units of British Columbia Children’s Hospital. Health outcomes were assessed in hospital, and at one, four, and twelve months using the PedsQL Generic and Infant Scales. Spatial clusters of very low, low, high, and very high outcomes were assessed using a spatial scan statistic designed for ordinal data, thus modeling outcome clusters across four health states. Clusters were mapped using Census Tracts for the Vancouver Metropolitan Area.
Results/outcomes
In the purely spatial analysis, five significant clusters of ‘very low’ physical and psychosocial health outcomes were identified within zones ranging in size from 1 to 21 km. A space-time analysis of outcomes identified significant clusters of both ‘very low’ and ‘low’ outcomes between survey months within zones ranging in size from 3 to 5 km.
Conclusions
Spatial scan models are employed in other public health studies for the detection of disease concentrations. This study utilized one type of spatial scan statistic to identify geographic clusters of those most at risk, or potentially at risk of a poor injury recovery. Such tools may be beneficial for monitoring trends in outcomes after injury as well as targeting or evaluating interventions.
Learning Areas:
Planning of health education strategies, interventions, and programsPublic health or related research
Learning Objectives:
Demonstrate the utility of using spatial scan statistic to monitor geographic clustering of recovery outcomes after injury.
Keyword(s): Geographic Information Systems (GIS), Surveillance
Qualified on the content I am responsible for because: I hold a PhD in Geography awarded from Simon Fraser University, where I wrote my dissertation on the social and spatial determinants of injury. My doctorate degree and post-doctorate training was funded through federal (Canadian Institutes of Health Research) and provincial (Michael Smith Foundation) scholarships and fellowships. I have over seven years experience using geographic information systems for studying the geographic and social determinants of injury.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.