Abstract Details Title Addressing The Traumatic Brain Injury Crisis In Thailand: Analysis Of National Access To Neurosurgical Facilities Utilizing Geospatial Mapping Topic General Neurology Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM) Poster/Presentation Number 6-028 Objective We aim to assess the accessibility to neurosurgical centers in Thailand for the management of traumatic brain injury (TBI) using a novel approach of geospatial mapping in low-middle income countries. Additionally, we seek to address issues of priority setting in hospital site selection accounting for national insurance schemes. Background Road traffic injuries are among the leading causes of death in Thai youth. TBI accounts for 65% of all motorcycle-crash fatalities. In recent years, the proportion of TBI patients has more than doubled, resulting in excessive burden of disease currently unmet by epidemiological strategy. Design/Methods Mapping neurosurgical accessibility in 77 provinces using population level data, spatial ancillary data, and reverse geocoding was conducted using ArcGIS. Mock-scenarios in which patients would have to be transferred to other hospital sites per the national insurance scheme were also assessed for the top-10 provinces with highest burden of disease. Results The percentage of the population with access to a neurosurgical facility within the golden hour is 22.6%, with the greatest disparity occurring in the northern border regions, where access time averages 180 minutes and only 12.3% of the population has access to neurosurgical care. Mock-scenarios analysis revealed that the current allocation of provincial hospital care accessible to a patient injured in a region to which they do not have access results in 78.2% excess delayed care. Conclusions With nearly 54 million people living too far away from a neurosurgical facility, that equates to 15,410 unnecessary deaths, given Thailand's high rate of mortality for TBI patients. The limitations of addressing this epidemiological gap include a lack of a national ambulance system with protocolized approaches to TBI management, brain-drain of neurosurgeons, and a lack of 24/7 neurosurgical care, which suggests that our findings may show an even larger disparity of care. Authors/Disclosures Arnav Mahajan PRESENTER Mr. Mahajan has nothing to disclose. No disclosure on file