Survival advantage associated with treatment of injury at designated trauma centers: a bivariate probit model with instrumental variables

Med Care Res Rev. 2007 Feb;64(1):83-97. doi: 10.1177/1077558706296241.


This article analyzes the effectiveness of designated trauma centers in Florida concerning reduction in the mortality risk of severely injured trauma victims. A bivariate probit model is used to compute the differential impact of two alternative acute care treatment sites. The alternative sites are defined as (1) a nontrauma center (NC) or (2) a designated trauma center (DTC). An instrumental-variables method was used to adjust for prehospital selection bias in addition to the influence of age, gender, race, risk of mortality, and type of injury. Treatment at a DTC was associated with a reduction of 0.13 in the probability of mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Demography
  • Efficiency, Organizational
  • Female
  • Florida / epidemiology
  • Humans
  • Male
  • Models, Statistical*
  • Survival Analysis
  • Trauma Centers*
  • Wounds and Injuries* / mortality