title: Variability in the characteristics and quality of care for injured youth treated at trauma centers.
abstract: OBJECTIVE
  To survey US level I trauma centers to assess the characteristics of child and adolescent psychosocial service delivery.
  
  
  METHODS
  Trauma program staff at US level I trauma centers were asked to complete a survey on the characteristics and quality of service delivery for youth. The presence of pediatric services and screening of injured youth for alcohol use problems and posttraumatic stress disorder symptoms were assessed.
  
  
  RESULTS
  A total of 150 of 202 trauma centers (74%) responded to the survey. Substantial variability was observed in trauma center age cutoff points for pediatric and adolescent patients. Although most sites endorsed having specialized pediatric, intensive care unit, and surgical services, marked differences were found in the reported percentage of youth receiving psychosocial services. Although most sites screened injured youth for alcohol use problems, variability was observed in the actual percentage of children and adolescents screened. Only 20% of sites endorsed specialized posttraumatic stress disorder services.
  
  
  CONCLUSIONS
  Our investigation observed marked variability across trauma centers in the delivery of child and adolescent services. Future research could develop high-quality pediatric psychosocial services to inform trauma center standards nationwide.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104, USA. dzatzick@u.washington.edu
authors.forename: Douglas F
authors.initials: DF
authors.lastname: Zatzick
authors.forename: Gregory
authors.initials: G
authors.lastname: Jurkovich
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D011787:Quality of Health Care; D012944:Social Support; D014193:Trauma Centers / Q000592:standards*; D014947:Wounds and Injuries / Q000628:therapy*; D055815:Young Adult