The year 2006 will mark the 40th anniversary of the establishment of
the first civilian trauma centers in the United States, at San Francisco General
Hospital and at Cook County Hospital in Chicago.1 The
same year also marks the 30th anniversary of the American College of Surgeons'
publication of the "Optimal Hospital Resources for Care of the Seriously Injured"
document.2 The parent document and subsequent
revisions articulate expert opinion on what constitutes categorization of
trauma centers, the resources required, and how trauma centers fit into a
system of care for the injured patient. The article by MacKenzie and colleagues3 in this issue of THE JOURNAL provides a national inventory
of hospital trauma centers. The study encompasses the last decade and updates
the report published in 1995.4 The findings
are noteworthy and have potentially important implications for health care
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