H-Index
79
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
15%
Acceptance
Rate
call: +1.631.470.9640
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
AmJCaseRep

Annals
ISI-Home

eISSN: 1643-3750

Get your full text copy in PDF

Regionalized trauma care system in Texas: Implications for redesigning trauma systems

Dan Culica, Lu Ann Aday, James E. Rohrer

Med Sci Monit 2007; 13(5): SR9-18

ID: 484618


Background: The aim of this investigation was to evaluate the theoretical framework of regionalized trauma care that places highest expertise at Level I and II Trauma Centers.
Material/Methods: To document appropriateness of regionalization the authors examined outcomes of all injured cases hospitalized over 2 years in trauma centers in Texas. The outcome measure was survival following an injury for cases that were treated in any trauma center.
Results: Survival was disproportionately lower at Level II and mostly Level I centers compared to centers with lower expertise. When adjusting for severity the difference in survival between centers was of smaller amplitude. Moreover, survival among the cases transferred to Level I and II trauma centers did not differ when adjusting for severity and mortality risk. Patients older than 45, of Hispanic origin, and with some type of insurance were less likely to survive at these centers. Lower survival was associated with shorter length of hospital stay and increased severity.
Conclusions: The study raises the question whether regionalization in its current form is the appropriate framework for the organization of trauma care in Texas. Small variation in survival among trauma centers with highest expertise, indicate the need to revisit the entire concept of regionalized trauma
care or particular elements of its structure. One solution suggested here is to have multiple centers with similar expertise at the core of the system acting as “Trauma Hospitals” which would connect with all the other hospitals in the region regardless of their expertise in an integrative model .

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree