Abstract
Trauma is a major public health issue. The management of seriously injured patients requires the integration of rescue and transport services, resuscitation and reconstructive care in dedicated centers with access to physical and vocational rehabilitation. The management of injury is exceedingly complex and expensive. We are entering a period of uncertainty due to the convergence of decreased reimbursement, more uncompensated care and fewer specialists willing to provide on-call services. The management of injury is costly yet has clear economic benefits based upon the potential to reduce mortality and mitigate disability. Trauma care also is very sustainable under favorable conditions including regionalized systems to support volume-driven proficiency, productive specialist staffing models, an evidence-based approach to technology and a high degree of physician-hospital integration.
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