Trauma Care Systems

Trauma Care Systems

The Problem

In the United States, as many as 35% of trauma patients who die do so because optimal acute care is not available. Despite evidence that trauma care systems save lives, existing systems serve only one-fourth of the U.S. population.

CDC's Accomplishments

Improving care through partnerships and research
Picture of hospital patient.

To increase the number and quality of trauma systems around the nation, CDC works extensively with public and private sector partners responsible for planning and developing such systems. For example, CDC collaborates with the National Highway Traffic Safety Administration on a project called "Trauma Vision," which engages experts and stakeholders in a consensus-building process to design optimal trauma care systems that meet community needs and, ultimately, reduce the adverse effects of injuries. CDC has also supported systematic reviews of scientific literature about patient outcomes in trauma systems and is currently funding a national study comparing outcomes and costs in hospital trauma centers and non-trauma center hospitals. Findings will enable community leaders to make informed decisions about establishing and supporting trauma centers and trauma care systems.

Program to establish single source of trauma data
When the American Trauma Society brings the CDC-funded Trauma Information and Exchange Program on line, policy makers, stake-holders, researchers and the public will have a convenient, single source for accessing trauma care data. This pilot program will offer data gathered through a variety of channels and promote more effective exchange of information.

CDC support leads to funding for Texas trauma care system
Responding to public interest, the 2000 Texas Legislature established a $10.5 million endowment using tobacco settlement money to support trauma care and continue injury prevention activities in that state. Public support for comprehensive trauma care grew when the Bureau of Emergency Management, Texas Department of Health, developed the Texas Trauma System. The system—established with CDC's consultation and funding—used regional area councils, composed of local health care providers and administrators, to increase community awareness of the importance of an integrated trauma care system.

Evaluation assesses complete system
With CDC funding and technical assistance, leading experts from the American College of Surgeons, the American College of Emergency Physicians, and other organizations evaluated the statewide trauma care system developed by the Montana Department of Health and Human Services. The evaluation looked at the trauma care network and injury prevention programs. It was the first effort to assess the total system, rather than focusing on trauma centers alone. Results of this evaluation will help improve the Montana system and guide the development of other state or regional trauma systems.

Study measures costs and outcomes of trauma care
CDC is funding the three-year National Study of Costs and Outcomes of Trauma to examine variations in care provided by both trauma centers and non-trauma center hospitals, to estimate the cost for patients treated at these centers, and to describe the relationship between costs and outcomes. Researchers will obtain medical and billing data for initial and subsequent injury-related hospitalizations and will conduct telephone interviews with patients to gather additional information about injury outcomes.

Addressing patient safety
The Injury Center is already working to prevent falls and pressure ulcers among patients in rehabilitation and long-term care settings. It is currently exploring how to extend this work to address patient safety more broadly.

Future Steps

There is much we don't know about the effectiveness of trauma care systems. Further evaluation is needed to better define their benefits and costs to society, to provide operational guidance for system planners, and to furnish practical measures for evaluating system performance.

Two ambulance medics with trauma patient. The Health Resources and Services Administration has lead federal responsibility for trauma care systems. However, CDC, with its experience working with data systems, is well-positioned to make significant contributions in this critical public health area. With additional resources, CDC can help set research priorities, provide technical assistance
for research programs, and translate new findings into practical measures and methods for evaluating trauma care systems.

CDC has helped develop tracking systems for detecting patient safety issues such as hospital-acquired infections. The Injury Center has the expertise needed to help extend these tracking and monitoring activities to injuries occurring in health care settings. With appropriate resources, Injury Center staff could work with other CDC professionals and with federal partners to develop operational definitions of specific types of patient injuries and incorporate them into tracking and reporting systems at the institutional, local, state, and national levels.

Just The Facts: What Is a Trauma Care System?

A trauma care system is an organized effort, coordinated by a state or local agency, to deliver the full spectrum of care (from acute care to rehabilitation) to injured persons in a defined geographic area. Such a system requires specially trained practitioners as well as adequate resources, equipment, and support personnel.

Trauma care systems are in various stages of development, implemen- tation, and evaluation, nationwide.

This page last reviewed July17, 2002

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