Trauma system evaluation using the fatality analysis reporting system.
BACKGROUND
The Fatality Analysis Reporting System (FARS) has recorded detailed data on fatal traffic crashes since 1975. At least three prior studies have used declining mortality rates derived from FARS as evidence of regional trauma system effectiveness.


METHODS
FARS and census data were obtained at no cost through the Internet. Previously published studies were replicated graphically including data from additional years before and after the previously reported time periods, and with rates also calculated for control populations.


RESULTS
The association of trauma system organization with observed decreases in mortality rates was less convincing when all available data were displayed and other potential factors were considered. Death after traffic crashes, and especially death in hospitals, is becoming less frequent throughout the country.


CONCLUSIONS
FARS is an excellent resource available to all injury researchers, but provides little evidence that some regions have decreased traffic mortality more than others because of trauma systems.
Clark
David E
DE
Department of Surgery, Maine Medical Center, Portland, USA. clarkd@mmc.org
D000063:Accidents, Traffic / Q000401:mortality* / Q000639:trends; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011159:Population Surveillance; D015397:Program Evaluation / Q000379:methods*; D012041:Regional Medical Programs / Q000458:organization & administration / Q000592:standards*; D012042:Registries; D012308:Risk Management / Q000379:methods*; D014193:Trauma Centers / Q000458:organization & administration / Q000592:standards* / Q000639:trends; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*