Alone in the wilderness: A comparison rural and non rural treating trauma centers

Introduction We know about outcomes of patients who come from rural areas, but we do not know about the patient characteristics and outcomes of people who are served by Rural Treating Trauma Centers (RTTC). We seek to describe the age, injury severity, and survival outcomes of people served in rural trauma centers compared to Non-Rural Treating Trauma Centers (NRTTC).

Methods This cohort study used the NTDB data for the years 2007 to 2009. To be included, RTTC's had to treat at least 500 patients during the study period. Statistical tests of comparison were used to calculate differences in age, gender, mechanism of injury, disposition, payment and survival using Stata 11 (College Station, TX) Results Eleven trauma centers met inclusion criteria as RTTC's. The remaining one hundred seventy-three trauma centers were NRTTC's. There were 36,982 patients in the eleven (11) RTTC's of which 34.46% were rural patients. Of the 324,555 patients in the NRTTC's, 4.05% were rural. RTTC's had a higher proportion of patients under 14 years of age and a lower proportion of those 65 years or greater than NRTTC. Rural patients had lower injury severity scores. Characteristics which were considered significant in the RTTC's included longer EMS transport time, shorter time in the emergency department and shorter hospital length of stay. Conclusions Survival at both types of centers was comparable. These data support the idea; RTTC's provide good quality care for the people they serve in spite of less favorable funding.