WASHINGTON - One hour can spell the difference between life and death for victims of severe injury, but about a quarter of Americans now have to travel farther to reach the nearest hospital trauma center, a study published Wednesday concludes.
The reason: Hundreds of trauma centers have closed over the past two decades.
Sixty-nine million people had to travel farther to reach a trauma center in 2007 than in 2001, according a study in the journal Health Affairs.
The median - or midpoint - increase in travel time was 10 minutes. But for nearly 16 million people, travel times increased by 30 minutes or longer.
Most of the trauma centers that closed were overwhelmed by financial problems from a combination of treating many uninsured patients who couldn't pay, and having to maintain high-level, life-saving capabilities on round-the-clock alert.
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The greatest impact has been on people in rural communities and in areas with high shares of African-American residents, low-income people and uninsured. The trend exacerbates disparities in health care.
Lead researcher Dr. Renee Hsia, an emergency room doctor at San Francisco General Hospital, said the study points to a need for state and regional coordination to reduce travel time to trauma centers. In rural areas, more resources may have to be devoted to air transport.
The researchers obtained longitude and latitude coordinates for every trauma center in the United States. They then measured driving distances and times between trauma centers and area ZIP codes, factoring in Census population data. They compared the results for 2001 and 2007, the latest year for which data were available.
Hsia said researchers were surprised. "A quarter of the population is significant," she said.
In 1990, there were 1,125 trauma centers around the nation. Fifteen years later, 339 had closed, or about 30 percent.
Designed and equipped to handle complex injuries, trauma centers are not the same as emergency rooms. A person with a broken leg should go to the emergency room; a victim with multiple fractures belongs in a trauma center. A patient with a concussion can be treated in the emergency room; someone with a brain injury should be taken to a trauma center.
The local angle
University of Arizona Medical Center-University Campus is Southern Arizona's only Level 1 trauma center. Tucson Medical Center closed its trauma unit in July 2003 at the same time that the former Kino Community Hospital, now known as University of Arizona Medical Center-South Campus, scaled back its emergency services.
Source: Arizona Daily Star archives
