TRAUMA CENTERSBY GABE S IEGEL

SHORT ANECDOTE Example: US Congressman Bobby Rush’s son was shot

and killed on the same block as a Hospital, yet he was driven 10.3 miles to the nearest trauma center.

STATE OF EMERGENCY MEDICINEEMTALA and the ACAInsurance ≠ Access: shortage of Primary

Care physiciansACA increases demand for resources Poor reimbursements, uncompensated

care, and utilization issuesImportance of Trauma centers and

systemsUnder the ACA: $224 million in grants for

Trauma Centers

TRAUMATrauma-mostly severe and critical injuries. Trauma is predictableInjury is the leading cause of death for

individuals from ages 1 to 44Accounts for approximately 170,000 deaths

each year and over 400 deaths per day35 million people are treated annually for

trauma -- one hospitalization every 15 minutes.

QUICK FACTFor every $3.51 the federal government

spends on HIV research and $1.65 for cancer, trauma gets 10 cents. And this is true despite the fact that someone dies from a traumatic injury every three minutes in the United States. Compared to every 9.5 minutes someone is infected with HIV/AIDS in the U.S.

DEFINING THE PROBLEM25 % of Trauma Centers have closed in the

U.SDisproportionately burdens vulnerable

populations46 million Americans lack access to a trauma

center. “Trauma Deserts”Access to a trauma center reduces risk of

death by 25%The interests, individuals, ideas, institutions

TRAUMA SYSTEM COMPONENTS911 AccessPre-Hospital ProvidersHospital EDsTrauma CentersRehabilitation CentersTrauma Registry and Injury

Prevention

TRAUMA CENTER LEVELSLevel 1- 24/7 emergency care

capable of providing care for any injury. Leader as a research institution.

Level 2- 24/7 essential care. Level 3- 24/7 emergency physicians,

key services, prompt availability of surgery staff, and transfer agreements.

Level 4- 24/7 physician coverage. Transfer agreements.

TRADE OFF PARALLELOGRAM

Cost Equity

Quality Access

POLICY PROPOSALRecognizing trauma systems as a public goodNational Trauma SystemLinking funds to Trauma center availability Increased and new modes of funding for EMS and

Trauma CentersChanging reimbursementActivation FeeAlternative payment model that incentives quality

outcomes and cost-effective careStopping “defensive medicine”

OUTCOMES AND OBSTACLESFundingPublic and professional support and policy

lighteningLowering mortality ratesMaintain and improve cost, quality, access, and

equityPrevention of Trauma Center closuresReducing “trauma deserts”Preparation for a major terrorist attack or disaster

TRAUMA MAPhttp://www.traumamaps.org/Trauma.aspx