Background-While efforts have been made to address disparities in access to trauma care in the past decade, there is little evidence to show if utilization has changed. We use patient-level data to describe the changes in utilization of trauma centers in an eight-year period in California. Results-The proportion of severe injuries admitted increased by 3.6% (p < 0.05), with a concomitant rise in the proportion of trauma patients admitted to trauma centers (TCs), from 39.3% (95% CI 39.0% -39.7%) to 49.7% (49.4% -50.0%). Within the severely injured with injury severity scores > 15, 82.4% were treated in a TC if they resided in a county with a TC, compared to 30.8% of patients who did not live in a county with a TC. After adjustment, patients living greater than 50 miles away from a TC still had a likelihood ratio of 0.11 (p<0.0001) of receiving care in a TC compared to those less than 10 miles away. Similarly, even severely injured patients not living in a county with a TC had a likelihood ratio of 0.35 (p<0.0001) of being admitted to a TC compared to those residing in counties with trauma centers.
Methods-We
Conclusion-Admissions toTCs for all categories of injury severity are increasing. There remains, however, a large disparity in TC care depending on geographical distance and availability of a TC within county.
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