Local Commentaries
6:54 am
Thu August 6, 2009

Bill Knight - August 6

Macomb, IL – Some 17 million American kids live farther than an hour away from a life-saving pediatric trauma center, according to a new study by researchers at Philadelphia's Children's Hospital and the University of Pennsylvania.

Maybe hospitals have abandoned areas with less population - and less revenue potential. Maybe area residents have traded convenience and safety for a rural lifestyle - although many have had little choice about where they live. Regardless, hurt children have farther to go to get help.

Dr. Michael L. Nance, lead author of the study, in the current Archives of Pediatrics and Adolescent Medicine journal, says, "This study shows that access to pediatric trauma centers is variable and inadequate in many areas of the U.S. Timely access to the best possible care is likely to save the lives of more children."

Trauma centers help severely injured patients of all ages, and in children younger than 15, injury causes more deaths than all other causes combined. While more than 70 percent of U.S. children can be transported by either ground or air to a pediatric trauma center within an hour, vast pockets live in regions that are farther away. Studies have shown similar gaps in the adult population living in rural areas.

The United States has about one pediatric trauma center for every 358,000 children, the report notes, drawing on data from the American College of Surgeons, which accredits most U.S. trauma centers, plus the American Trauma Society list of adult centers designated as "pediatric capable," and the National Association of Children's Hospitals and Related Institutions, whose members self-classify as trauma centers.

Although one pediatric trauma center for every 358,000 sounds inadequate, the situation may be worse. Most such centers are in more urban areas, meaning that many cities have multiple centers while more rural areas have none at all. In west-central Illinois, general trauma centers are located in Galesburg, Quincy, Burlington, Iowa, and Peoria, according to ATS. However, parts of Fulton, Henry, Mason and McDonough plus Brown, Putnam and Schuyler are more than an hour away from trauma centers by ground or air transportation, ATS says.

The study added that care delivered to children in an adult-care setting more than an hour away may be adequate, but it's difficult to tell if the best care is available to most severely injured rural kids. Nance and his team said their goal is to help create a national inventory of pediatric trauma centers to better identify where there are gaps and hopefully provide better vital care for American kids.

Nance said, "The lack of a single national accrediting body or uniform standards for pediatric trauma centers has been an obstacle to understanding the resources that exist for the care of our most severely injured children. A reliable inventory of accredited pediatric trauma centers will allow for expansion of resources into areas currently underserved."

So will private, for-profit medical providers step up to improve access to more remote residents, or will government intervene to help families get trauma care for kids.

Or will rural populations continue to be forced to make sacrifices because of where they live?