Background: Little is known about the influence of regionalization of trauma care on pediatric trauma care delivery. The purpose of this study was to estimate whether formal adoption of a statewide trauma system was associated with hospital admission patterns of injured children.
Methods: A longitudinal study of children who were residents of Washington State during 1989 to 1999 was conducted. The main outcome measure was hospital admission for trauma.
Results: During the 11-year period, there were 24,955 admissions. Admission rates of injured children to pediatric-designated trauma hospitals decreased by 20%, rates at adult-designated hospitals decreased by 60%, and rates at nondesignated hospitals decreased by 66%. Introduction of the trauma system in 1994 was associated with a 12% increase in admission rates to pediatric-designated hospitals, little change (+1%) in admission rates to adult-designated centers, and an 11% decrease in admissions at nondesignated hospitals.
Conclusion: Trauma designation in Washington was associated with a shift in admissions from nondesignated hospitals to pediatric trauma hospitals.