AN ANALYSIS OF THE ASSOCIATION OF TRAUMA CENTERS WITH PER-CAPITA HOSPITALIZATIONS AND DEATH RATES FROM INJURY

Objective This study used population-based data bases to assess the as sociation of trauma centers with per capita county hospitalization and trauma death rates in the State of North Carolina. Summary Background Data The current study extended previous work using two North Carolin a data bases to assess the association of the presence of a trauma cen ter with per capita county trauma death rates. Methods Data on per cap ita county trauma hospitalizations and deaths were obtained from the s tate hospital discharge data base and the North Carolina Medical Exami ner's data base. Bivariate and multivariate analysis techniques were u sed. The dependent variables of interest were prehospital. hospital, a nd total trauma death rates and hospitalization rates for injury. Resu lts Bivariate analysis identified a number of factors associated with per capita county hospitalizations and trauma death rates. These inclu ded the per cent unemployment, racial distribution, county alcohol tax receipts, and advanced lite support certified emergency medical servi ces providers. The per capita trauma death rates were significantly lo wer in counties with trauma centers compared with those without trauma centers (4.0 +/- 0.5 and 5.0 +/- 1.1 deaths per 10,000 population, p = 0.0001, respectively), The per capita hospitalizations for trauma we re also lower in counties with trauma centers. Multivariate modeling s howed that the presence of a trauma center and advanced life support p roviders were the best predictors of decreased per capita county traum a death rates. Conclusions The study showed that the presence of a tra uma center and advanced life support training were the two medical sys tem factors that were the best predictors of the per capita county pre hospital and total trauma death rates. These findings are consistent w ith the hypothesis that trauma centers are associated with a decrease in trauma death rates.