title: Survival advantage for elderly trauma patients treated in a designated trauma center.
abstract: BACKGROUND
  This article analyzes the effectiveness of designated trauma centers (DTCs) in Florida concerning reduction in the mortality risk of severely injured elderly trauma victims.
  
  
  METHODS
  Inpatient hospital data collected by the Agency for Health Care Administration were used to identify elderly trauma patients. An instrumental variables method was used to adjust for prehospital selection bias in addition to the influence of age, gender, race, risk of mortality, comorbidities, and type of injury. The model was estimated using a bivariate probit full information maximum likelihood model to determine the impact of triage to a trauma center as opposed to a nontrauma hospital.
  
  
  RESULTS
  After adjusting for confounding influences, treatment at a DTC was associated with a statistically significant reduction of 0.072, 0.040, and 0.036 in the probability of mortality for patients in the age groups 65 years to 74 years, 75 years to 84 years, and ≥ 85 years, respectively.
  
  
  CONCLUSIONS
  Treatment of severely injured elderly trauma patients in DTCs is associated with statistically significant gains in the probability of survival.
authors.affiliation: Health Policy and Management, Tampa, FL, USA. epracht@health.usf.edu
authors.forename: Etienne E
authors.initials: EE
authors.lastname: Pracht
authors.forename: Barbara
authors.initials: B
authors.lastname: Langland-Orban
authors.forename: Lewis
authors.initials: L
authors.lastname: Flint
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005431:Florida / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy