Original ArticleAccess to Trauma Systems in CanadaHameed, Syed Morad MD, MPH; Schuurman, Nadine BSc, MA, PhD; Razek, Tarek MDCM, FRCSC, FACS; Boone, Darrell MD, FRCSC, FACS; Van Heest, Rardi MD, MA, FRCSC; Taulu, Tracey RN, BSCN, MHS; Lakha, Nasira RN, BSCN; Evans, David C. MD; Brown, D. Ross MD, FRCSC, FACS; Kirkpatrick, Andrew W. MD, FRCSC; Stelfox, Henry T. MD, PhD; Dyer, Dianne BN, MN; van Wijngaarden-Stephens, Mary MD, FRCSC, FACS; Logsetty, Sarvesh MD; Nathens, Avery B. MD, FRCSC, FACS, PhD, MPH; Charyk-Stewart, Tanya MSc; Rizoli, Sandro MD, PhD; Tremblay, Lorraine N. MD, PhD; Brenneman, Frederick MD; Ahmed, Najma MD, PhD, FACS; Galbraith, Elsie RN; Parry, Neil MD, FRCSC, FACS; Girotti, Murray J. MD, FRCSC, FACS; Pagliarello, Guiseppe MD, FRCSC; Tze, Nancy BScN, MBA; Khwaja, Kosar MD, MBA, FRCS; Yanchar, Natalie MD, MSc, FRCSC; Tallon, John M. MSc, MD, FRCPC; Trenholm, J. Andrew I. MD, FRCSC; Tegart, Candance RN, BSN; Amram, Ofer BA; Berube, Myriam BSc; Hameed, Usmaan MD; Simons, Richard K. MB, BCHIR, FRCSC for the Research Committee of the Trauma Association of Canada Author Information From the Research Committee of the Trauma Association of Canada, Calgary, Alberta, Canada. Submitted for publication January 29, 2010. Accepted for publication May 11, 2010. Supported by the Canadian Institutes for Health Research and the Michael Smith Foundation for Health Research grants. Presented at the Annual Scientific Meeting of the Trauma Association of Canada, May 6–7, 2010, Halifax, Nova Scotia, Canada. Address for reprints: Morad Hameed, MD, MPH, Trauma Services VGH, 855 West 12 Avenue, Vancouver, British Columbia V5Z 1M9, Canada; email: [email protected]. The Journal of Trauma: Injury, Infection, and Critical Care: December 2010 - Volume 69 - Issue 6 - p 1350-1361 doi: 10.1097/TA.0b013e3181e751f7 Buy Metrics Abstract Background: Trauma is a leading cause of morbidity, potential years of life lost and health care expenditure in Canada and around the world. Trauma systems have been established across North America to provide comprehensive injury care and to lead injury control efforts. We sought to describe the current status of trauma systems in Canada and Canadians' access to acute, multidisciplinary trauma care. Methods: A national survey was used to identify the locations and capabilities of adult trauma centers across Canada and to identify the catchment populations they serve. Geographic information science methods were used to map the locations of Level I and Level II trauma centers and to define 1-hour road travel times around each trauma center. Data from the 2006 Canadian Census were used to estimate populations within and outside 1-hour access to definitive trauma care. Results: In Canada, 32 Level I and Level II trauma centers provide definitive trauma care and coordinate the efforts of their surrounding trauma systems. Most Canadians (77.5%) reside within 1-hour road travel catchments of Level I or Level II centers. However, marked geographic disparities in access persist. Of the 22.5% of Canadians who live more than an hour away from a Level I or Level II trauma centers, all are in rural and remote regions. Discussion: Access to high quality acute trauma care is well established across parts of Canada but a clear urban/rural divide persists. Regional efforts to improve short- and long-term outcomes after severe trauma should focus on the optimization of access to pre-hospital care and acute trauma care in rural communities using locally relevant strategies or novel care delivery options. © 2010 Lippincott Williams & Wilkins, Inc.