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Impact of pediatric trauma center designation on the state-level trauma system

Steve Janda, RN, Director, Office of EMS/Trauma Systems Coordination, Texas Department of State Health Services, 1100 W 49th Street, Austin, TX 78756, 512-834-6745, Steve.Janda@dshs.state.tx.us

Texas has over 24 million residents, 28% of whom are under 18 years of age. There are 248 designated trauma centers in the state, but only two of them are free-standing pediatric hospitals. Over 4 million Texas children are without access to a pediatric hospital that has met the standards of a designated trauma facility.

The Texas trauma system developed nearly 20 years ago as a result of a legislative mandate to improve access to trauma care for acutely injured persons. Relatively few hospitals chose to join the system at its inception, but a recent state funding provision to offset the cost of providing uncompensated care created a dramatic increase in participation. Despite these incentives, most free-standing pediatric hospitals in Texas have not pursued trauma center designation. The lack of pediatric trauma care weakens the state-level trauma system by increasing the fiscal burden on adult trauma centers, which are left with the added costs of equipment and personnel needed to care for the occasional pediatric patient. It also limits access to adult patients when local trauma centers have maximized their available resources.

Governance of the Texas trauma system is a function of the stake holders, therefore, participation of pediatric trauma providers to the organizational system makes certain pediatric patients have advocates in the decision-making process. Increasing the number of designated pediatric trauma centers strengthens the system as a whole, and improves both pediatric and adult access to quality emergency medical care.

Learning Objectives:

Keywords: EMS/Trauma, Public Health Infrastructure

Presenting author's disclosure statement:

Any relevant financial relationships? No

Systems of Care for Pediatric Trauma: Issues and Experiences

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA