Association of hospital trauma designation with admission patterns of injured children.
BACKGROUND
Little is known about the influence of regionalization of trauma care on pediatric trauma care delivery. The purpose of this study was to estimate whether formal adoption of a statewide trauma system was associated with hospital admission patterns of injured children.


METHODS
A longitudinal study of children who were residents of Washington State during 1989 to 1999 was conducted. The main outcome measure was hospital admission for trauma.


RESULTS
During the 11-year period, there were 24,955 admissions. Admission rates of injured children to pediatric-designated trauma hospitals decreased by 20%, rates at adult-designated hospitals decreased by 60%, and rates at nondesignated hospitals decreased by 66%. Introduction of the trauma system in 1994 was associated with a 12% increase in admission rates to pediatric-designated hospitals, little change (+1%) in admission rates to adult-designated centers, and an 11% decrease in admissions at nondesignated hospitals.


CONCLUSIONS
Trauma designation in Washington was associated with a shift in admissions from nondesignated hospitals to pediatric trauma hospitals.
Vavilala
Monica S
MS
Department of Anesthesiology, University of Washington School of Medicine, Harborview Medical Center, Seattle, Washington 98104-2499, USA. vavilala@u.washington.edu
Cummings
Peter
P
Sharar
Sam R
SR
Quan
Linda
L
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000592:standards; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D014193:Trauma Centers / Q000458:organization & administration* / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy*