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Wednesday, Aug 20, 2014
Editorials

The dangers of a trauma center glut

Published:

The idea of building more trauma centers that treat severely injured patients sounds appealing.

After all, quick medical care saves lives, so why shouldn’t hospitals be allowed to invest in trauma centers if they want to treat these patients?

But the issue is not so simple.

Treating the desperately injured or ill doesn’t exactly lend itself to free-market competition.

And litigation by several hospitals with trauma centers, including Tampa General Hospital and St. Joseph’s Hospital, to force new trauma centers in Manatee and Pasco to close is not the ham-fisted attack on competition it may seem.

At stake is the quality of Florida’s trauma centers, which require highly trained, experienced physicians and sophisticated equipment.

There simply are neither enough cases nor specialists to sustain unlimited trauma centers, particularly since trauma medical teams require a high volume of patients to maintain their expertise.

High patient volume also helps hospitals fund the costly trauma centers.

Adding more trauma centers means existing ones are likely to lose patients, physicians and revenue. That won’t improve the quality of care.

Florida saw what happened with a liberal trauma center policy in the 1980s when 21 centers had to close.

The hospitals challenging the new trauma centers contend that the Department of Health never should have approved them.

An appeals court found that the Department of Health used an outdated rule when reviewing proposed trauma centers. Nevertheless, the agency allowed trauma centers at Blake Medical Center in Manatee and Regional Medical Center in Pasco to open in 2011.

The Department of Health then ruled Tampa General, St. Joseph’s, Bayfront Center in St. Petersburg and Shands Jacksonville Medical Center did not have standing to challenge the approval.

In September the 1st District Court of Appeal found the hospitals did have standing, and now they are pushing for the trauma centers to be closed. They make a strong case that the existing network of 22 trauma centers were already meeting the state’s needs prior to the Department of Health approving the trauma requests by for-profit hospitals.

Moreover, as the American College of Surgeons found in its review of the state’s trauma regulatory system, 97 percents of Floridians live within an hour of a trauma facility. The national average is 82 percent. The state’s average is higher than the five most populous states.

This doesn’t seem like the state was in desperate need for more trauma centers, given that the centers need high patient volumes to be effective.

However this litigation turns out, it is important the Department of Health develop a better approval process, one that recognizes that when it comes to trauma centers more is not necessarily better.

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