title: Towards Regionalized Care of Severe Orthopedic Injuries: A Survey on Non-university Hospitals in Finland.
abstract: BACKGROUND
  The principles of a designated trauma system and regionalization of trauma care exist in very limited areas in Finland. In this study, we obtained information on the current personal opinions of orthopedicsin-chief (OICs) and surgeons-in-chief (SICs) towards regionalization of severe orthopedic trauma care in Finland.
  
  
  METHODS
  A questionnaire was sent to OICs and SICs working in 36 primary and secondary hospitals providing acute surgical care asking to give their personal opinions whether certain severe orthopedic injuries should be managed in their hospitals or be referred.
  
  
  RESULTS
  The overall response rate was 49/67 (73%). In general, SICs tended to be more reluctant to refer patients to higher level facilities. Both OICs and SICs were more willing to refer spinal and pelvic injuries than complicated long bone fractures.
  
  
  CONCLUSIONS
  There seems to be major differences in personal views on referral policy between OICs and SICs. This information is useful prior to discussions by the professional organizations, hospitals, and the government in establishing a modern orthopedic trauma system in Finland.
authors.affiliation: Department of Orthopaedics and Traumatology, Töölö Hospital, University of Helsinki, Finland. lauri.handolin@hus.fi.|Department of Orthopaedics and Traumatology, Töölö Hospital University of Helsinki, Topeliuksenkatu 5, 00260, Helsinki, Finland. lauri.handolin@hus.fi.
authors.forename: Lauri
authors.initials: L
authors.lastname: Handolin
authors.affiliation: Pelvis and Lower Extremity Trauma Unit, Töölö Hospital, University of Helsinki, Helsinki, Finland.
authors.forename: Jan
authors.initials: J
authors.lastname: Lindahl
authors.affiliation: Department of Traumatology, Oulu University Hospital, Helsinki, Finland.
authors.forename: Martti
authors.initials: M
authors.lastname: Lakovaara
authors.affiliation: Section of Orthopaedics, Department of Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Vihtonen
authors.affiliation: Department of Surgery, Meilahti Hospital, University of Helsinki, Helsinki, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Leppäniemi
keywords: Orthopedic trauma; Regionalization; Trauma care