Trauma system structure and viability in the current healthcare environment: A state-by-state assessment

Objective: Anecdotal reports suggest that some state trauma systems are struggling to remain solvent while others appear stable in the current health care environment. The purpose of this research is to characterize the current structure and viability of state trauma systems in the U.S. Methods: Expert panels were convened in all 50 states to characterize the current structure of trauma care and to identify strengths, weakness, opportunities and threats facing trauma care delivery in each state. Results: States continue to value the formalization of trauma systems. System operations, evaluation/research methods and trauma leadership are highly valued by states with mature systems. However, all states consider their trauma system severely threatened by inadequate funding and difficulty recruiting and retaining physicians and nurses. Conclusion: Trauma care systems are valued and demonstrate potential for future expansion. However, economic shortfalls and retention of medical personnel threaten the viability of current systems across the U.S.