Too many trauma centers?

While having multiple level I trauma centers capable of taking care of the most seriously injured patients might seem like a good thing, some places are seeing an oversupply — mainly because trauma care can be profitable for hospitals.

But the American College of Surgeons, which sets the standards for trauma centers, said today in a new policy statement that trauma center designation should be based on the needs of the community, rather than the desires of individual hospitals.

Dr. Ronald Stewart, a trauma surgeon at University Hospital and chairman of surgery at the UT Health Science Center, who also serves as chair of the College of Surgeons’ Committee on Trauma, said that the purpose of trauma systems is to have the optimal care available for injured patients.

“We believe it is very important to the injured patient to get this balance right, thus the need for this position statement,” Dr. Stewart said.

The new policy statement contains guidelines for trauma systems to function at the highest levels. One of the key principles is that trauma centers should be designated by the governmental agency that oversees regional trauma systems, and that agency should be guided by the local needs of the population being served, rather than individual healthcare organizations or hospital groups.”

The Texas Department of State Health Services designates trauma centers in Texas, based in part on American College of Surgeons criteria. The state is divided into trauma regions, with San Antonio part of the 22-county Trauma Service Area P. Within that region, University Hospital and the San Antonio Military Medical Center are the level I trauma centers — a number that area health officials have long maintained works well for the area.

Problems occur, according to the statement, “when a lead agency passively allows health care organizations and hospital groups to establish new trauma centers in areas that yield an economic advantage, while ignoring areas of true need.”

“My hopes are that we, all the elements of the trauma system, are committed to doing the right thing and doing things right for our patients and our fellow citizens—this includes all patients and all regions of the country,” Dr. Stewart said.

The position statement, developed by the Committee on Trauma’s Trauma Systems Evaluation and Planning Committee, was approved by the College of Surgeons’ Board of Regents last fall and published in the Bulletin of the American College of Surgeons.

Photo by Mark Greenberg Photography