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February 1995

Invited Commentary

Author Affiliations

Maywood, Ill

Arch Surg. 1995;130(2):193. doi:10.1001/archsurg.1995.01430020083015

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A trauma care system is an organized approach to the acutely injured patient that provides personnel, facilities, and equipment on an emergency basis within a defined geographic region. Heretofore, the favorable impact of trauma care systems and the justification for their implementation were measured by reductions in mortality and morbidity compared with localities without such systems. While saving lives and returning injured people to their preinjury status makes sense economically, data supporting such financial savings are difficult to tease out.

In this report, Miller and Levy compare medical payments in groups of injured patients with non–life-threatening trauma: injuries to the upper and lower extremities and back in states with and without organized systems of trauma care. The results are encouraging.

Because the state of readiness required of a trauma system tends to drive up the cost of providing care, the reduction in medical payments at first appears unexpected. After all,

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