California Trauma Center Closures Lead to Increased Risk of Death
Injured individuals in California whose travel times to trauma centers increased after a nearby trauma center closed were 21% more likely to die from their injuries than patients with similar injuries, according to a study published Thursday in the Journal of Trauma and Acute Care Surgery, Kaiser Health News' "Capsules" reports.
The study was conducted by researchers from UC-San Francisco's Clinical and Translational Science Institute and the Robert Wood Johnson Foundation's Physician Faculty Sponsor Program.
For the study, researchers examined more than 250,000 adult visits to California trauma centers from 1999 to 2009.
They compared the risk of dying for 5,122 patients whose drive time to a trauma center increased after a nearby trauma center closed with 266,023 patients whose travel time did not change.
The study found that patients who had to travel 47 minutes to get to the closest trauma center were more likely to die from their injuries than those who drove an average of 34 minutes.
Researchers also found that individuals whose travel times increased were more likely to be:
- Black or Hispanic;
- Uninsured or covered by Medi-Cal, the state's Medicaid program; and
In addition, the study found that injured individuals who lived near a closed trauma center were 29% more likely to die in the hospital during the first two years after the center's closure, compared with individuals who lived near an operating trauma center. Similarly, the study found that patients whose travel times to a trauma center decreased were 17% less likely to die than individuals whose commute remained constant.
Renee Hsia, lead author of the study and associate professor of emergency surgery at UCSF, said the findings suggest that trauma center closures in urban areas could be contributing to economic health disparities.
According to "Capsules," trauma centers operated by public hospitals and those located in urban areas are more likely to close because of high operating costs and low Medi-Cal reimbursement rates.
Hsia said, "Hospitals in affluent areas fight to open trauma centers" because they can charge high fees for services, adding, "But if you're in a poor area with a lot of violence, these trauma patients pour in and you provide a lot of high intensity care and you're not reimbursed -- those hospitals cannot survive."
The study said health care stakeholders and policymakers must develop a way "to ensure equitable access" to trauma centers for all (Rabin, "Capsules," Kaiser Health News, 3/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.