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Indiana Trauma System Highlights
Trauma refers to people who have sustained moderate to severe injuries, requiring rapid evaluation and transport to hospitals with trauma centers that are best equipped to provide the comprehensive care needed. All hospital emergency departments are not trauma centers. A trauma system is an organized, coordinated effort in a geographic area that delivers the full range of care to all injured patients. Until March 2006, Indiana was among a handful of states with no laws or regulations granting oversight authority for trauma care. Proper oversight is a necessary element of any trauma system. Public Law 155, enacted in 2006 with support from resolutions by the Indiana State Medical Association and the Indiana Emergency Nurses Association, changed that situation. This legislation designated the Indiana State Department of Health (ISDH) as the lead agency for a state trauma care system with goals of preventing injuries and coordinating care for injured patients in order to reduce death and disability. No funding was appropriated with this legislation; in fact, of all the states, Indiana appropriates the lowest per capita funding for public health programs. This lack of focus on public health programs is one reason Indiana lags behind many states in trauma system development.
Trauma significantly impacts the lives of Hoosiers. Consider that injury — not cancer or any disease — is the leading cause of death for state citizens 1 to 34 years of age. More than 95,000 Hoosiers are hospitalized and more than 5,000 die from injuries each year. The monetary cost to Hoosiers each year is astronomical. Just the subset of alcohol-related motor vehicle crashes (only 24% of Indiana’s crash costs) cost the public an estimated $2.4 billion in 1998, including $1.1 billion in monetary costs and almost $1.3 billion in quality of life losses. Add the remainder of the motor vehicle crashes along with all of the other causes of injuries, and the cost to Hoosiers is estimated to be in the $10’s of billions. The costs of these traumatic injuries can be significantly reduced through timely and effective treatment of the injuries as well as through effective injury prevention programs ($1 spent on a child safety seat saves $32 in direct medical costs; $1 spent on bicycle helmets saves $30 in direct medical costs; $1 spent on a smoke alarm saves $69 in fire related costs & $21 in direct medical costs).
Indiana currently has no state funding for trauma system development and infrastructure support. However, the ISDH has successfully acquired and used federal funding to begin development and implementation of a statewide trauma system. Trauma system development is currently funded by a grant from the HRSA Rural Hospital Flexibility grant, supporting the fulltime position of the contracted trauma program manager. The ISDH also recently acquired funding from the TRCC which administers the NHTSA 408 traffic records grant. This funding supports the contracted trauma registrar position and development of the state trauma registry. The EMS Commission in the IDHS is funded by EMS provider certification fees.
Indiana has 129 acute care hospitals with emergency departments, as of August, 2007; this includes two Veterans' Administration Hospitals operated by the federal government, one in Indianapolis and one in Fort Wayne. The count excludes 20 long-term care and/or rehabilitation hospitals, as well as psychiatric hospitals. Sixteen of the 92 counties in Indiana do not have a hospital: Newton, Benton, Carroll, Fountain, Parke, Owen, Brown, Union, Franklin, Ohio, Switzerland, Martin, Pike, Crawford, Spencer, and Posey. Currently, 46 of the 129 acute care hospitals in the state are considered rural (located in Non-Metropolitan Counties). Thirty-five Indiana Hospitals are designated as Critical Access Hospitals.Access to Trauma Centers by Ambulance
Access to Trauma Centers by Helicopter
