title: Access to trauma systems in Canada.
abstract: BACKGROUND
  Trauma is a leading cause of morbidity, potential years of life lost and health care expenditure in Canada and around the world. Trauma systems have been established across North America to provide comprehensive injury care and to lead injury control efforts. We sought to describe the current status of trauma systems in Canada and Canadians' access to acute, multidisciplinary trauma care.
  
  
  METHODS
  A national survey was used to identify the locations and capabilities of adult trauma centers across Canada and to identify the catchment populations they serve. Geographic information science methods were used to map the locations of Level I and Level II trauma centers and to define 1-hour road travel times around each trauma center. Data from the 2006 Canadian Census were used to estimate populations within and outside 1-hour access to definitive trauma care.
  
  
  RESULTS
  In Canada, 32 Level I and Level II trauma centers provide definitive trauma care and coordinate the efforts of their surrounding trauma systems. Most Canadians (77.5%) reside within 1-hour road travel catchments of Level I or Level II centers. However, marked geographic disparities in access persist. Of the 22.5% of Canadians who live more than an hour away from a Level I or Level II trauma centers, all are in rural and remote regions.
  
  
  CONCLUSIONS
  Access to high quality acute trauma care is well established across parts of Canada but a clear urban/rural divide persists. Regional efforts to improve short- and long-term outcomes after severe trauma should focus on the optimization of access to pre-hospital care and acute trauma care in rural communities using locally relevant strategies or novel care delivery options.
authors.affiliation: Research Committee of the Trauma Association of Canada, Calgary, Alberta, Canada. morad.hameed@vch.ca
authors.forename: Syed Morad
authors.initials: SM
authors.lastname: Hameed
authors.forename: Nadine
authors.initials: N
authors.lastname: Schuurman
authors.forename: Tarek
authors.initials: T
authors.lastname: Razek
authors.forename: Darrell
authors.initials: D
authors.lastname: Boone
authors.forename: Rardi
authors.initials: R
authors.lastname: Van Heest
authors.forename: Tracey
authors.initials: T
authors.lastname: Taulu
authors.forename: Nasira
authors.initials: N
authors.lastname: Lakha
authors.forename: David C
authors.initials: DC
authors.lastname: Evans
authors.forename: D Ross
authors.initials: DR
authors.lastname: Brown
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Kirkpatrick
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
authors.forename: Dianne
authors.initials: D
authors.lastname: Dyer
authors.forename: Mary
authors.initials: M
authors.lastname: van Wijngaarden-Stephens
authors.forename: Sarvesh
authors.initials: S
authors.lastname: Logsetty
authors.forename: Avery B
authors.initials: AB
authors.lastname: Nathens
authors.forename: Tanya
authors.initials: T
authors.lastname: Charyk-Stewart
authors.forename: Sandro
authors.initials: S
authors.lastname: Rizoli
authors.forename: Lorraine N
authors.initials: LN
authors.lastname: Tremblay
authors.forename: Frederick
authors.initials: F
authors.lastname: Brenneman
authors.forename: Najma
authors.initials: N
authors.lastname: Ahmed
authors.forename: Elsie
authors.initials: E
authors.lastname: Galbraith
authors.forename: Neil
authors.initials: N
authors.lastname: Parry
authors.forename: Murray J
authors.initials: MJ
authors.lastname: Girotti
authors.forename: Guiseppe
authors.initials: G
authors.lastname: Pagliarello
authors.forename: Nancy
authors.initials: N
authors.lastname: Tze
authors.forename: Kosar
authors.initials: K
authors.lastname: Khwaja
authors.forename: Natalie
authors.initials: N
authors.lastname: Yanchar
authors.forename: John M
authors.initials: JM
authors.lastname: Tallon
authors.forename: J Andrew I
authors.initials: JA
authors.lastname: Trenholm
authors.forename: Candance
authors.initials: C
authors.lastname: Tegart
authors.forename: Ofer
authors.initials: O
authors.lastname: Amram
authors.forename: Myriam
authors.initials: M
authors.lastname: Berube
authors.forename: Usmaan
authors.initials: U
authors.lastname: Hameed
authors.forename: Richard K
authors.initials: RK
authors.lastname: Simons
mesh_terms: D002170:Canada; D002391:Catchment Area, Health; D006297:Health Services Accessibility; D006801:Humans; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D014195:Travel