Population-based research assessing the effectiveness of trauma systems

J Trauma. 1999 Sep;47(3 Suppl):S59-66. doi: 10.1097/00005373-199909001-00013.


Objective: To review published evidence regarding the effectiveness of trauma systems by using population-based data.

Design: A systematic review of peer-reviewed literature assessing the influence of trauma system implementation on the outcome of all injured patients.

Materials and methods: Literature available in MEDLINE, HealthSTAR, and CINHAL was reviewed for studies that use population-based data to assess the benefit of trauma system development. Studies were included that assessed trauma systems in North America and used a comparison or control group in the analysis.

Main results: Published evidence, reported for eight of the nine trauma systems evaluated, demonstrates improved outcomes, principally measured as hospital survival. Improvement occurred after the trauma system or some component of a trauma system (e.g., sophisticated prehospital care) was established.

Conclusion: Population-based evidence supports a 15 to 20% improved survival rate among seriously injured patients with trauma system implementation. Future study is required to determine whether trauma systems improve the outcome of all injured patients, not just high-risk subsets of the population.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review
  • Systematic Review

MeSH terms

  • Community Health Planning
  • Databases, Factual*
  • Health Services Research
  • Humans
  • Outcome Assessment, Health Care / methods*
  • Population Surveillance*
  • Program Evaluation
  • Regional Medical Programs / standards*
  • Regional Medical Programs / statistics & numerical data
  • Survival Rate
  • Trauma Centers / standards*
  • Trauma Centers / statistics & numerical data
  • United States / epidemiology
  • Wounds and Injuries / epidemiology*