Rural Calif. Counties Designating Local Hospitals for Trauma Care

Some rural California counties that lack trauma centers have begun designating local hospitals to deliver such care, HealthyCal reports.

Background                        

According to a report by the state Emergency Medical Systems Authority, 20% to 40% of injury-related deaths would not occur if the patients received adequate help in a timely manner.

Hospitals designated as trauma centers must meet American College of Surgeons standards.

The centers can be designated by different levels. A lower level center does not require as many staff members to be present, while higher level centers must have surgeons and other medical personnel available at all times.

Details of Rural Access to Trauma Care

Bonnie Sinz, with California's EMS Authority, said five California counties traditionally have had limited access to trauma care:

• Monterey;
• San Benito;
• Santa Cruz;
• San Luis Obispo; and
• Tuolumne.

Sinz said that individuals in those counties often face challenges in accessing trauma care because of the distance or difficulty of transportation.

According to a grand jury report, weather forces emergency crews to seek alternate transportation routes nearly 33 times per year. In addition, air transportation can be expensive, costing as much as $30,000 per trip, according to HealthyCal.

To increase access to trauma care, several of the counties that lack trauma centers have begun designating local hospitals to offer trauma care. For example:

• San Luis Obispo officials in 2012 chose Sierra Vista Regional Medical Center to offer level-three trauma care; and
• Monterey County in 2013 began negotiations with Natividad Medical Center to change staffing to enable the facility to qualify as a level-two trauma center.

Challenges Remain

However, observers note that the cost of additional staffing at trauma centers also can be a deterrent to designation.

Sinz said, "In the rural areas of the state, we could agree that trauma center access is difficult," adding, "There are few hospitals in those areas that have the resources available to commit to a higher level of trauma center designation" (Griffy, HealthyCal, 2/12).