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 MEDICINE

EMTALA 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

TRAUMA

Trauma-mostly severe and critical injuries.

Trauma is predictable

Injury is the leading cause of death for individuals from ages 1 to 44

Accounts for approximately 170,000 deaths each year and over 400 deaths per day

35 million people are treated annually for trauma -- one hospitalization every 15 minutes.

QUICK FACT

For 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 PROBLEM

25 % of Trauma Centers have closed in the U.S

Disproportionately burdens vulnerable populations

46 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 COMPONENTS

911 Access

Pre-Hospital Providers

Hospital EDs

Trauma Centers

Rehabilitation Centers

Trauma Registry and Injury Prevention

TRAUMA CENTER LEVELS

Level 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 PROPOSAL

Recognizing trauma systems as a public good

National Trauma System

Linking funds to Trauma center availability

Increased and new modes of funding for EMS and Trauma Centers

Changing reimbursement

Activation Fee

Alternative payment model that incentives quality outcomes and cost-effective care

Stopping “defensive medicine”

OUTCOMES AND OBSTACLES

Funding

Public and professional support and policy lightening

Lowering mortality rates

Maintain and improve cost, quality, access, and equity

Prevention of Trauma Center closures

Reducing “trauma deserts”

Preparation for a major terrorist attack or disaster

TRAUMA MAP

http://www.traumamaps.org/Trauma.aspx