Citation

Nathens AB, Jurkovich GJ, MacKenzie EJ, Rivara FP. J. Trauma 2004; 56(1): 173-178.

Affiliation

Division of Trauma and General Surgery, Harborview Medical Center and Department of Surgery, University of Washington, Seattle, 98104-2499, USA. anathens@u.washington.edu

Copyright

(Copyright © 2004, Lippincott Williams and Wilkins)

DOI

10.1097/01.TA.0000056159.65396.7C

PMID

14749585

Abstract

BACKGROUND: The resources needed and those available to support trauma care for a given region are currently unknown. Resource use and availability were evaluated for injured subjects across a large sample of the United States. METHODS: This population-based study of trauma-related discharges in 18 states represented all four geographic regions of the United States. Hospital discharge and bed-utilization rates as a function of injury severity were assessed. Resource availability was evaluated by determining state trauma center density. RESULTS: This study evaluated 523,780 trauma patients discharged from 2,317 hospitals. The discharge rate for all trauma was 412 per 100,000 person-years, whereas the rate for major trauma was only 44 per 100,000 person-years. More than one third of the patients with major trauma received care at centers not designated for trauma care. The hospital bed utilization rate was 2,095 days per 100,000 person-years. The availability of trauma centers varied greatly across states, ranging from 0.9 to 6.6 centers per million population. CONCLUSIONS: A substantial minority of major trauma patients in the United States are treated in nondesignated trauma centers. The variability in the availability of trauma resources indicates a lack of consensus with respect to the resources required for trauma system implementation.