title: Population-based research assessing the effectiveness of trauma systems.
abstract: OBJECTIVE
  To review published evidence regarding the effectiveness of trauma systems by using population-based data.
  
  
  METHODS
  A systematic review of peer-reviewed literature assessing the influence of trauma system implementation on the outcome of all injured patients.
  
  
  METHODS
  Literature available in MEDLINE, HealthSTAR, and CINHAL was reviewed for studies that use population-based data to assess the benefit of trauma system development. Studies were included that assessed trauma systems in North America and used a comparison or control group in the analysis.
  
  
  RESULTS
  Published evidence, reported for eight of the nine trauma systems evaluated, demonstrates improved outcomes, principally measured as hospital survival. Improvement occurred after the trauma system or some component of a trauma system (e.g., sophisticated prehospital care) was established.
  
  
  CONCLUSIONS
  Population-based evidence supports a 15 to 20% improved survival rate among seriously injured patients with trauma system implementation. Future study is required to determine whether trauma systems improve the outcome of all injured patients, not just high-risk subsets of the population.
authors.affiliation: Department of Surgery, Oregon Health Sciences University, School of Medicine, Portland 97201-3098, USA. mullinsr@ohsu.edu
authors.forename: R J
authors.initials: RJ
authors.lastname: Mullins
authors.forename: N C
authors.initials: NC
authors.lastname: Mann
mesh_terms: D018672:Community Health Planning; D016208:Databases, Factual; D006302:Health Services Research; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011159:Population Surveillance; D015397:Program Evaluation; D012041:Regional Medical Programs / Q000592:standards* / Q000706:statistics & numerical data; D015996:Survival Rate; D014193:Trauma Centers / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*