ArticleThe journal of trauma and acute care surgery2022
Do new trauma centers provide needed or redundant access? A nationwide analysis.
Article in The journal of trauma and acute care surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed.
- Improving care and equity in the American trauma system: past, present and future.Trauma surgery & acute care open · 2025Article
- Access, delivery and outcomes: the summit on the advancement of Focused Equity Research in Trauma (SAFER-Trauma).Trauma surgery & acute care open · 2025Review
- System-Level Variability in Trauma Center Utilization for Seriously Injured Older Adults.The Journal of surgical research · 2025Article
- Geographic Disparity in Distance to Trauma Care in Secondary Schools Across the United States.Journal of athletic training · 2024Article
- Impact of lower level trauma center proliferation on patient outcomes.Surgery open science · 2024Article
- Changes in payer mix of new and established trauma centers: the new trauma center money grab?Trauma surgery & acute care open · 2024Article
- Crossing the line: access to trauma care across state borders.Trauma surgery & acute care open · 2024Article
- Population need versus trauma center financial sustainability: striking the right balance.Trauma surgery & acute care open · 2024Article
- Redefining trauma deserts: novel technique to accurately map prehospital transport time.Trauma surgery & acute care open · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundOur prior research has demonstrated that increasing the number of trauma centers (TCs) in a state does not reliably improve state-level injury-related mortality. We hypothesized that many new TCs would serve populations already served by existing TCs, rather than in areas without ready TC access. We also hypothesized that new TCs would also be less likely to serve economically disadvantaged populations.
methodsAll state-designated adult TCs registered with the American Trauma Society in 2014 and 2019 were mapped using ArcGIS Pro (ESRI Inc., Redlands, CA). Trauma centers were grouped as Level 1 or 2 (Lev12) or Level 3, 4 or 5 (Lev345). We also obtained census tract-level data (73,666 tracts), including population counts and percentage of population below the federal poverty threshold. Thirty-minute drive-time areas were created around each TC. Census tracts were considered "served" if their geographic centers were located within a 30-minute drive-time area to any TC. Data were analyzed at the census tract level.
resultsA total of 2,140 TCs were identified in 2019, with 256 new TCs and 151 TC closures. Eighty-two percent of new TCs were Levels 3 to 5. Nationwide, coverage increased from 75.3% of tracts served in 2014 to 78.1% in 2019, representing an increased coverage from 76.0% to 79.4% of the population. New TC served 17,532 tracts, of which 87.3% were already served. New Lev12 TCs served 9,100 tracts, of which 91.2% were already served; new Lev345 TCs served 15,728 tracts, of which 85.9% were already served. Of 2,204 newly served tracts, those served by Lev345 TCs had higher mean percentage poverty compared with those served by Lev12 TCs (15.7% vs. 13.2% poverty, p < 0.05). DISCUSSION: Overall, access to trauma care has been improving in the United States. However, the majority of new TCs opened in locations with preexisting access to trauma care. Nationwide, Levels 3, 4, and 5 TCs have been responsible for expanding access to underserved populations. LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level IV.
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