Teenage drivers just one reason we need trauma centers

Friday, February 23, 2007

The results of a just-released national study serve as a chilling reminder that teenagers have a much higher risk of dying or suffering severe injuries in a traffic accident than do older, more experienced drivers.

The study, conducted by the Children's Hospital of Philadelphia and State Farm Insurance Co., found that while an overwhelming majority of teens say they rarely or never drive after drinking or using drugs, it's quite common for them to operate vehicles while talking on cell phones, text-messaging, playing hand-held games or being distracted by their teenage passengers.

Traffic accidents are the number one killer of U.S. teens, who have a fatality rate four times higher than drivers aged 25-69.

The study should also send a chilling reminder of the importance of hospital trauma centers, which differ substantially from standard emergency rooms. Trauma centers require a wide array of resources -- specialized physicians and nurses, surgeons, state-of-the-art equipment such as CT scans and MRIs, special intensive-care beds and operating rooms on standby. All personnel must be available at a moment's notice, around the clock, seven days a week, 365 days a year. That makes them very expensive to operate.

Tennessee's trauma care system includes six Level I trauma centers, which treat the most severely injured trauma victims, one Level II center and three Level III centers, for a total of 10. The good news is that virtually all Tennesseans and visitors to our state are within 100 air miles of a Level I trauma center.

The bad news is that the number of Level II and III centers has decreased from seven to four since 2002 because of the high cost of operating them, which has increased the patient-load burden, and therefore the financial burden, on the Level I centers, which are seeing a growing number of trauma patients who are either uninsured or underinsured. Hospitals have traditionally underwritten the gap between services provided and payments, but the gap for trauma centers is widening.

In 2005, the total uncompensated trauma costs for Tennessee Level I trauma centers was $37.6 million. That figure includes uncompensated costs from the uninsured and uncompensated TennCare care costs. In addition, Level I trauma centers incur an additional "readiness cost" of about $14 million per center per year. The readiness costs include funding to meet equipment, space, physicians and 24/7 availability of surgery and other services.

A statewide coalition of health professionals has launched an education campaign to raise awareness about Tennessee's trauma care system and the need to ensure its continuing viability. It's an important effort because every Tennessean is at risk of needing the lifesaving services of their nearest trauma center.

Tennessee is not alone. Many other states are facing serious challenges in their trauma care systems, including the neighboring states of Georgia and Mississippi. In the last 18 months, 32 trauma centers across the country have closed.

The leading cause of trauma injuries by far is accidents involving motor vehicles, which include cars, trucks, motorcycles and ATVs. Because of the state's geographic shape and its system of high-traffic interstate highways (I-40 from east to west, I-65 from north to south, I-24 from Chattanooga to Clarksville, I-55 through Memphis and I-81 across Upper East Tennessee), not to mention the grid of state and county roads, it is clear that a network of strategically sited trauma centers is essential.

Having access to a trauma center is not the only key factor for the severely injured. Time is also critical. Statistics show that those who receive care within one hour -- what trauma professionals call the "Golden Hour" -- have a much higher chance of surviving their injuries and avoiding permanent disabilities.

The Tennessee Trauma Coalition is working hard to make sure all Tennessee trauma victims have a chance to receive care within the Golden Hour. We are talking to business and civic groups. We are talking to local and state government officials to make them aware of the problem and to seek their help in finding permanent solutions. We have launched a Web site, www.tntrauma.org that is loaded with information and ways that individuals can join the effort.

The statistics tell us that today, even as you read this column, a Tennessee teenager is going to be involved in an automobile accident. Timely access to a trauma center may mean the difference between life and death.