title: Trauma system structure and viability in the current healthcare environment: a state-by-state assessment.
abstract: OBJECTIVE
  Anecdotal reports suggest that some state trauma systems are struggling to remain solvent while others appear stable in the current health care environment. The purpose of this research is to characterize the current structure and viability of state trauma systems in the U.S.
  
  
  METHODS
  Expert panels were convened in all 50 states to characterize the current structure of trauma care and to identify strengths, weakness, opportunities and threats facing trauma care delivery in each state.
  
  
  RESULTS
  States continue to value the formalization of trauma systems. System operations, evaluation/research methods and trauma leadership are highly valued by states with mature systems. However, all states consider their trauma system severely threatened by inadequate funding and difficulty recruiting and retaining physicians and nurses.
  
  
  CONCLUSIONS
  Trauma care systems are valued and demonstrate potential for future expansion. However, economic shortfalls and retention of medical personnel threaten the viability of current systems across the U.S.
authors.affiliation: Intermountain Injury Control Research Center, University of Utah School of Medicine, Salt Lake City, Utah 84108-1284, USA. clay.mann@hsc.utah.edu
authors.forename: N Clay
authors.initials: NC
authors.lastname: Mann
authors.forename: Ellen
authors.initials: E
authors.lastname: Mackenzie
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Teitelbaum
authors.forename: Dagan
authors.initials: D
authors.lastname: Wright
authors.forename: Cheryl
authors.initials: C
authors.lastname: Anderson
mesh_terms: D006302:Health Services Research; D006801:Humans; D011795:Surveys and Questionnaires; D014193:Trauma Centers / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D014481:United States