Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

04 May 2007

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

Abstract

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 .

Keywords: Triage, Trauma Severity Indices, Trauma Centers, Texas, Survival Analysis, Outcome Assessment (Health Care), Odds Ratio, Length of Stay, Infant, Newborn, Child, Preschool, Child, Adolescent

0 Comments

Editorial

04 June 2022 : Editorial  

Editorial: Acute Hepatitis of Unknown Origin in Children. Is Autoimmunity at Play?

Nahum Mendez-Sanchez, Shreya C. Pal
Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico

DOI: 10.12659/MSM.937371

Med Sci Monit 2022; 28:e937371

SARS-CoV-2/COVID-19

27 June 2022 : Clinical Research  

Shoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who...

Med Sci Monit In Press; DOI: 10.12659/MSM.937430  

27 May 2022 : Clinical Research  

Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)

Med Sci Monit 2022; 28:e936547

In Press

30 Jun 2022 : Clinical Research  

Antioxidant System and Ions Concentrations After Femoral Neck and Resurfacing Hip Arthroplasty

Med Sci Monit In Press; DOI: 10.12659/MSM.936335  

28 Jun 2022 : Meta-Analysis  

Urodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-Analysis

Med Sci Monit In Press; DOI: 10.12659/MSM.937166  

28 Jun 2022 : Clinical Research  

Serum Calprotectin – a NET Product – as a Biomarker of Disease Activity in Patients with Systemic Lupus Ery...

Med Sci Monit In Press; DOI: 10.12659/MSM.936534  

28 Jun 2022 : Database Analysis  

LINC00963 May Be Associated with a Poor Prognosis in Patients with Cervical Cancer

Med Sci Monit In Press; DOI: 10.12659/MSM.935070  

Most Viewed Current Articles

30 Dec 2021 : Clinical Research  

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...

DOI :10.12659/MSM.935379

Med Sci Monit 2021; 27:e935379

08 Mar 2022 : Review article  

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...

DOI :10.12659/MSM.936292

Med Sci Monit 2022; 28:e936292

01 Nov 2020 : Review article  

Long-Term Respiratory and Neurological Sequelae of COVID-19

DOI :10.12659/MSM.928996

Med Sci Monit 2020; 26:e928996

01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750