Community hospitals don’t often transfer severely injured patients to higher-level trauma centers that could provide the care they need, a new study says.
Fewer than half of severely injured people are transferred from a low-level trauma center to larger or more advanced hospitals, researchers reported in the Journal of the American College of Surgeons.
The results reveal holes in hospital networks intended to get trauma patients the best care, researchers said.
“We need to develop state systems that are inclusive of all hospitals so that every person, regardless of where they are, gets optimal care and is treated at the right place for their injuries,” senior researcher Dr. Marta McCrum, an associate professor of surgery at the University of Utah in Salt Lake City, said in a news release.
Trauma center certification falls into three levels, with Level III hospitals serving communities without timely access to more advanced Level I or II medical centers, researchers said in background notes.
For the new study, researchers analyzed 2019 data on nearly 147,000 patients with a severe injury treated at a hospital ER.
In all, 1 in 3 trauma patients were first treated at either a Level III center or a hospital that doesn’t have a trauma center certification, researchers said.
Researchers found that 58% of those patients were not transferred to a Level I or II center, even though they might have benefitted from higher-level care.
Elderly folks were less likely to be transferred, the results showed. People 80 and older had 68% higher odds of being kept at the lower-level hospital.
People on public insurance also were less likely to be transferred, with Medicare recipients 76% more likely to be kept and Medicaid patients 44% more likely.
Level III trauma centers were three times more likely to not transfer patients, researchers found. Hospitals located in urban areas were five times more likely to hold patients rather than transfer them.
“Overall, Level III hospitals need to be brought into what we consider to be high-level trauma systems so that we can better support these centers in the trauma care that they do provide and ensure the best possible outcomes for all patients,” McCrum said.
Dr. Avery Nathens, medical director of the American College of Surgeons Trauma Quality Programs, reviewed the findings.
These results “show that while Level III trauma centers play an important role for the communities in which they are located, we have work to do to strengthen our trauma systems to ensure all patients get the care they need,” he said in a news release.
“By ensuring all trauma centers meet high standards of care and are part of an integrated trauma system, there is no compromise in the quality of trauma care and we can optimally care for all injured patients,” added Nathens, who was not involved in the study.
More information
The Cleveland Clinic has more on traumatic injury.
SOURCE: American College of Surgeons, news release, Aug. 27, 2025
Source: HealthDay
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