APSA papersDo pediatric patients with trauma in Florida have reduced mortality rates when treated in designated trauma centers?
Section snippets
The Florida Trauma System
The first legislation concerning the Florida Trauma System was enacted in 1982 and required the Department of Health and Rehabilitative Services to verify that DTCs met established guidelines. Florida's trauma laws and regulations were further developed and expanded in 1987 and 1990. By 2004, the Florida Department of Health designated 20 hospitals as DTCs. These included 6 Level I, 12 Level II, and 2 pediatric trauma centers (PDTCs). All 6 Level I and 4 Level II trauma centers also met medical
Methods
Florida AHCA inpatient discharge data sets from 1995 to 2004 were analyzed. These data sets contain information concerning patient demographic and case-mix–related characteristics, such as age, sex, race, type of diagnosis, source of admission, and discharge status. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify a study population consisting of 5 groups of patients with trauma who sustained (a) fractures (of the skull, neck, and
Results
Table 2 lists the demographic and mortality distributions of patients. The number of pediatric patients with trauma, aged 0 to 19 years, included in the overall analysis was 27,313. Approximately 60% of these children were treated in a DTC. A little more than 46% were transported to a PDTC. The overall mortality rate of pediatric patients with trauma was 3.22% but increased to 4.23% when only DTC-treated pediatric patients were included. The rate increased slightly to 4.39% when the population
Discussion
The efficacy of systems of trauma care in saving lives and preserving quality of life is now well established and validated [1], [2], [3], [4], [5], [6], [7]. How these advances in systems of care apply to children is still not completely defined, especially with regard to the concept of institutional qualifications. Children's hospitals exist for the sole purpose of providing a full range of child-specific resources for every patient. Trauma centers, which often are not collocated with
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Cited by (0)
Presented at the 38th annual meeting of the American Pediatric Surgical Association, Orlando, Florida, May 24-27, 2007.