By Suzanne Hoholik
The Columbus Dispatch
COLUMBUS, Ohio — Ohio’s trauma law was created to ensure that severely injured patients are treated at hospitals best staffed and equipped to save their lives.
But getting and maintaining trauma status can be costly.
As a result, apparently, “in today’s economic environment, (trauma) centers are reconsidering their commitment to trauma,” said Dr. Charles J. Yowler, trauma director at MetroHealth Medical Center in Cleveland. “Any major trauma guy in the country will tell you they’ve heard that.”
He said officials at several Ohio hospitals are talking about getting rid of their trauma designation.
Trauma experts worry that hospitals that drop their trauma designations might still treat severely injured patients even though they might not maintain the required specialists — orthopedic surgeons, neurosurgeon — who must be on-call.
Studies have found that severely injured patients treated at nontrauma centers have a greater risk of bad outcomes, including death.
At a May meeting of the Ohio chapter of the American College of Surgeons, officials from MedCentral Health System in Mansfield told members that the hospital was considering dropping its Level II trauma status.
Last week, however, MedCentral officials said the hospital plans to renew its trauma verification when it expires next spring.
Yowler said some Cleveland-area Level II trauma centers also have floated the idea of dropping that status.
Trauma verification, which is performed by the American College of Surgeons every three years, costs at least $10,000. The big expense, however, is the staff needed for a 24-hour trauma program.
Since the law was enacted in 2002, two hospitals — Upper Valley Medical Center, a Level III center in Troy, and Good Samaritan Hospital, a Level II center in Dayton — have dropped out.
The talk among other centers has state officials dusting off part of the law that directs hospitals how to transition from trauma center to regular hospital. These steps include transferring severely injured patients to trauma centers, notifying state health and safety officials and other hospitals of the change, and no longer advertising as a trauma center.
Some trauma experts question whether the rules will be followed and what can be done if a hospital breaks them.
The state trauma committee acknowledges that the law lacks teeth. The Ohio EMS Division’s authority in the trauma law stops at hospital doors.
“If the law doesn’t have any designated authority or any penalty clause, why spend the money on verification?” said Dr. Sidney Miller, an Ohio State University Medical Center burn doctor and member of the state trauma committee.
However, others say that former trauma centers will follow the law.
“If a hospital had a mental-health unit and closed that down, they wouldn’t continue to take mental-health patients,” said Tiffany Himmelreich, spokeswoman for the Ohio Hospital Association.
“It’s the same thing with trauma status; they’d assess if a person is a trauma patient and transfer them accordingly.”
But Miller wants to make sure and wants the law changed to enforce the trauma rules.
“Unless there’s a fairly strong public sentiment for it or a champion in the legislature, it’s not going to happen,” he said.
Copyright 2009 The Columbus Dispatch
All Rights Reserved