TY  - JOUR
T1  - ACcess to trauma centers in the united states
AU  - Branas CC, MacKenzie EJ, Williams JC, et al
Y1  - 2005/06/01
N1  - 10.1001/jama.293.21.2626
JO  - JAMA
SP  - 2626
EP  - 2633
VL  - 293
IS  - 21
N2  - Context 
                  Previous studies have reported that the number and distribution of trauma
centers are uneven across states, suggesting large differences in access to
trauma center care.Objective 
                  To estimate the proportion of US residents having access to trauma centers
within 45 and 60 minutes.Design and Setting 
                  Cross-sectional study using data from 2 national databases as part of
the Trauma Resource Allocation Model for Ambulances and Hospitals (TRAMAH)
project. Trauma centers, base helipads, and block group population were counted
for all 50 states and the District of Columbia as of January 2005.Main Outcome Measures 
                  Percentages of national, regional, and state populations having access
to all 703 level I, II, and III trauma centers in the United States by either
ground ambulance or helicopter within 45 and 60 minutes.Results 
                  An estimated 69.2% and 84.1% of all US residents had access to a level
I or II trauma center within 45 and 60 minutes, respectively. The 46.7 million
Americans who had no access within an hour lived mostly in rural areas, whereas
the 42.8 million Americans who had access to 20 or more level I or II trauma
centers within an hour lived mostly in urban areas. Within 45 and 60 minutes,
respectively, 26.7% and 27.7% of US residents had access to level I or II
trauma centers by helicopter only and 1.9% and 3.1% of US residents had access
to level I or II centers only from trauma centers or base helipads outside
their home states.Conclusion 
                  Selecting trauma centers based on geographic need, appropriately locating
medical helicopter bases, and establishing formal agreements for sharing trauma
care resources across states should be considered to improve access to trauma
care in the United States.
SN  - 0098-7484
M3  - doi: 10.1001/jama.293.21.2626
UR  - http://dx.doi.org/10.1001/jama.293.21.2626
ER  -