Kokomo Tribune; Kokomo, Indiana

May 3, 2013

Indiana needs more trauma centers

State working on trauma system plan.

By Ken de la Bastide
Tribune staff writer

Muncie — [Editor’s Note: This is part one of two stories looking at area access to trauma care. A story appearing in the April 14 edition explored how Indiana compares to other states and whether Howard County is a likely candidate for a trauma center. Coming tomorrow, the Tribune will examine how the state is working to develop a more comprehensive network of trauma care and possible funding sources for it.]

In 2010, more than 200 people died from trauma-related injures in the district that includes Howard, Tipton and Grant counties, but there are no trauma centers in the region.

With only nine trauma centers in the state, Indiana is working to develop a statewide trauma system that will provide treatment to trauma patients within 45 minutes. Studies have shown the death rate from traumatic injuries declines by up to 25 percent when a patient gets to a trauma center quickly.

In 2006, the Indiana General Assembly gave the Indiana State Department of Health responsibility for the development of a statewide trauma system.

The ISDH conducted a meeting Tuesday in Muncie to receive input from local emergency medical services managers on how to provide trauma center services to the rural population of the state. There were no representatives from Howard or Tipton counties at the meeting.

In 2010, 63 people in the district died from fall-related injuries, 61 were killed in traffic accidents, six deaths and eight hospitalizations for burns, and 73 deaths and 14 hospitalizations due to firearms injuries.

Art Logsdon, assistant ISDH commissioner, said currently, Indiana has nine trauma centers located in Indianapolis, Fort Wayne, South Bend and Evansville. Those are Level 1 and Level 2 trauma centers, the highest designated by the American College of Surgeons.

“Indiana is one of only six states in the nation without a statewide trauma system,” he said.

Logsdon said Indiana needs 13 or 14 trauma centers and there is a need for Level 3 trauma centers, which can provide trauma care to most patients and would transport those needing more advanced medical care to a higher level center.

“We’re making progress,” he said, “but we have a long way to go.”

Logsdon said the current trauma centers are not geographically accessible throughout the state. Ohio has 45 trauma centers, he said, which may be too many.

He said it is important for the state to get trauma center services in rural areas. Logsdon said large portions of the state are not within 45 minutes of a trauma center using ground transportation.

“It’s discouraging when you focus on areas outside of the 45 minute area,” he said.

The ISDH said trauma injuries are the No. 1 killer of Indiana residents under the age of 45 and there were 3,000 trauma-related deaths in the state in 2010.

In the U.S., 60 percent of the trauma-related deaths take place where just 25 percent of the population resides.

Logsdon said the American College of Surgeons, which designates a hospital as a trauma center, did a study in 2008 of the needs in Indiana and made 80 recommendations.

Logsdon said the ISDH is evaluating the entire trauma system and collecting crucial data. A pilot program for a trauma injuries registry has been begun and the state is working toward a designation program which would have requirements beyond the American College of Surgeons verification process.

Currently, the nine trauma centers and 31 other hospitals are reporting data to the registry with the goal being all hospitals with an emergency department provide information.

“We want a complete record of trauma care in Indiana,” Logsdon said. “The data can be used to lower health care costs and to identify needs.”

The state is working on an optimal course to assist hospitals wanting to become designated as a trauma center and guide them through the process.

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