Ariel S Winn, Kathleen Huth, Alan M Leichtner, Lori R Newman
Beyond the Workshop: Results From a Longitudinal, Interprofessional Teaching Certificate Program
Journal of medical education and curricular development
objective implicit expectation pioneers trauma system design high clinical volume select centers could lead superior outcomes little study regionalization pediatric craniospinal trauma care whether continues trend direction regionalization unknown motivating hypothesis study trauma system design united states proceeding rational basis producing hospital caseloads increasing time geographic siting appropriate needs catchment areas increasingly uniform manner methods data obtained kids inpatient database kid 1997 2000 2003 2006 2009 2012 cases traumatic spinal injury tsi severe traumatic brain injury stbi identified icd9 diagnostic procedural codes records patients 18 years age older excluded hospital caseloads descriptive statistics calculated year study trends examined distributions hospital caseloads compared year year simulations idealized systems results caseloads tsi trended upward caseloads stbi stable despite declining nationwide incidence conditions study period pool hospitals providing services pediatric craniospinal trauma contracted degree distributions hospital caseloads change every year study large numbers hospitals reported small numbers discharges last year study quarter children tsi discharged hospitals treated approximately 1 case fewer every month quarter children stbi discharged hospitals treated 1 case fewer every 3 months conclusions previous study nationwide trends pediatric craniospinal trauma caseloads analysis hospital caseloads 1997 2012 supports inference persisting geographical mismatch population needs availability services observations falsify study hypothesis notable fraction pediatric craniospinal trauma care continues rendered lowcaseload institutions novel quality assurance methods tailored needs lowcaseload institutions deserve development study