TRAUMA CENTER 2000 - HOW MANY AND WHICH T RAUMA CENTERS WILL EUROPE NEED IN THE YEAR 2000

The treatment of severely injured patients is a challenge for preclini cal and clinical treatment concepts, causing financial aspects of incr easing importance for the German health care system. A total of 32,500 polytraumatized patients (PTS III and IV) are managed in trauma cente r levels I-IV in Germany. Trauma center levels I or II are by definiti on capable of supporting the full range of treatment for the severely injured. With the baseline calculation of 64,000 DM per patient and 10 4 polytrauma treated per year in the Berlin Virchow Clinic, 6.66 milli on DM primary costs must be spent for treatment. The total annual cost s of this center are nearly 24 million DM for emergency cases and 7 mi llion DM fixed costs per year, for a trauma center level I. In Europe the distribution of trauma center levels I or II is sufficient and can be specified with 1 center per 1 million inhabitants. Nevertheless, t he european air medical service could support more intensive use of th ese central trauma institutions. This was shown by comparing the numbe r of polytrauma patients and the number of trauma centers. Less then h alf of these patients are treated in levels I or II trauma centers. Th e financial pressure on the health system and the rising quality must lead to better utilization of trauma centers. To meet this goal a annu al treatment rate of 300-400 polytrauma patients should be aimed at. T he claim of the American College of Surgeons that a trauma surgeon sho uld treat 50 severely injured patients per year would then be possible .