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Invited Commentary
April 2014

Should Regionalization Only Be in 1 Direction?

Author Affiliations
  • 1National Capital Region, Johns Hopkins Medicine, Suburban Hospital, Bethesda, Maryland
  • 2SUNY Downstate School of Public Health, Brooklyn, New York
JAMA Surg. 2014;149(4):327-328. doi:10.1001/jamasurg.2013.4861

The article by Matsushima et al1 gives a new perspective on regionalization of care for trauma. In elderly patients who have been treated at level 1 and level 2 trauma centers in Pennsylvania, the authors noted a 25% decrease in mortality for those at centers that treat more than 100 geriatric patients annually. These high-volume geriatric trauma centers have lower rates of major complications, even lower incidences of failure to rescue after a major complication when compared with centers with fewer than 100 such patients annually. Conversely, at institutions that have larger numbers of nongeriatric trauma patients, there was a significantly higher rate of major complications for elderly individuals.

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