Trauma center designations
Level I: The highest level of trauma center and a regional resource center. Level 1 centers have a full range of surgical and medical specialists with resources available around the clock. They are required to have either: a) 1,200 patients admitted annually, regardless of severity; b) 240 critically injured patients admitted per year; or c) each trauma surgeon treats at least 35 critically injured patients each year. It also must have a research program.
Level II: Similar to a Level 1, but no volume requirements or research obligation.
Level III: Does not have full availability of surgical and medical specialists, but does have resources for emergency resuscitation, surgery and intensive care of most trauma patients. Such trauma centers often are located at rural or community hospitals.
Source: Ohio Department of Public Safety
KETTERING — A May 2009 study of trauma patient outcomes at Ohio hospitals, published in the Journal of Trauma, found patients taken to Level I centers had improved survival and better functional outcomes than those patients taken to Level II trauma centers.
That could reflect the higher volumes of patients handled by Level I trauma centers during 2003 through 2006, the years covered by the study. Level I trauma centers must handle at least 1,200 admissions a year, while Level II centers are not subject to such volume requirements.
The Dayton Daily News this week confirmed Kettering Medical Center is planning to open a Level II trauma center. KMC also is pursuing a neonatal intensive care unit for extremely premature or critically ill newborns, commonly called a Level III NICU. That project could draw newborns from Level III NICUs at Miami Valley Hospital and the Children’s Medical Center of Dayton.
KMC did not disclose the cost of its trauma center project, the number of jobs it would create, or when it would open. It has declined repeated requests for comment.
It also was not clear whether KMC’s trauma program would include helicopter transports, similar to CareFlight at Miami Valley Hospital, which has the region’s only Level I trauma center.
But Connie Potter, president of the Trauma Center Association of America, said trauma centers can have positive ripple effects for entire hospitals.
“It’s going to help all kinds of patients” in terms of patient care, she said.
Potter also said reimbursement for trauma care has improved in recent years, and said well-run trauma centers often break even or contribute positively to the bottom line.
“It may actually increase the efficiency of the hospital by evening out the resource allocation of personnel,” Potter said.
Mary Boosalis, executive vice president and chief operating officer of Premier Health Partners, parent of Miami Valley Hospital, noted the amount of uncompensated care provided to the uninsured is a key factor in the financial performance of a trauma center.
Premier, which competes head-to-head with Kettering Medical Center and its parent, Kettering Health Network, doesn’t think the region needs another high-level trauma center.
“It’s in the millions of dollars to set up a trauma program at a 2 or 1 level,” Boosalis said.
Potter said trauma cases often come in groups, such as an automobile crash with multiple injuries. Such events could overwhelm a single trauma center, she said. “There is a potential in a disaster situation where one hospital would be overwhelmed,” she said.
But Good Samaritan Hospital closed its trauma center in 2006. At the time, officials said it was getting more difficult to justify spending more than $1 million a year when Miami Valley Hospital had a Level I trauma center.
Good Samaritan and Miami Valley hospitals are both part of Premier Health Partners.
Boosalis said Miami Valley’s trauma center has never had to turn away a trauma patient.
“We think we’re meeting the community need,” Boosalis said. “It’s a very complex thing to go into and it’s something that takes years to hone the level of expertise.”
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