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FOR RELEASE: November 6, 2003
CONTACT: Pamela Williams
Office of Communications

Potential Loss of Level 1 Trauma Unit Worries State Health Officials

The planned reclassification of the Level 1 Trauma Unit at OU Medical Center to a lower level will result in delays in access to care for severely injured people, and could contribute to adverse medical outcomes, say officials at the Oklahoma State Department of Health.

“If we lose the state’s only Level 1 Trauma Unit, then we have lost an important resource in a meaningful system of trauma care in Oklahoma,” said Interim State Health Commissioner Dr. Mike Crutcher.

Crutcher said the loss of a functioning trauma system could result in some patients being sent to hospitals in Texas or Kansas, if specialists willing to take call cannot be found in Oklahoma.

All licensed hospitals that provide emergency care in Oklahoma are identified and classified into four categories, according to the extent of stabilizing and definitive emergency services they provide. Level I provides the most comprehensive level of care while Level IV indicates the capability to provide stabilizing care and referral to a higher level of care.

State licensure requirements for hospitals require that they give 30 days advance notice if they plan to change their level of care in any of the classified levels of care. OU has not formally advised the state health department of their plan to reclassify their Level I trauma unit.

A high rate of uninsured motorists, low insurance requirements, and the high cost of maintaining the specialist coverage necessary to maintain Level I or Level II classification have all been cited by hospitals as reasons for downgrading their classification.

Trauma is the third leading cause of death overall, behind heart disease and cancer; however, trauma results in more years of potential life lost (average 37 years) than any other disease process. Each year between 2,000 and 2,500 Oklahomans die from trauma. Many times that number of citizens sustain lifelong disabilities because appropriate medical intervention did not take place in a timely manner.

Conservative estimates of the costs of trauma (medical, property, loss of productivity, etc.) in Oklahoma each year put it over $ 1.5 billion, more than $400 for every man, woman, and child living in Oklahoma.

A trauma system is an organized approach to coordinating a multidisciplinary response to severely injured patients. Using models of formal trauma care systems from other states, the Oklahoma State Department of Health estimates Oklahoma could be saving approximately 17 percent to 20 percent (350 to 400) persons who die from injury, and significantly reduce or prevent hundreds of lifelong disabilities.

The Oklahoma State Department of Health and professionals from throughout the state have been working since 1993 to establish a statewide trauma system. The focus has been to get victims into the hands of trauma specialists as quickly as possible. As part of this process:

  • Hospitals have been required since 1999 to participate in the classification of their level of emergency service capability. This system enables Emergency Medical Service providers and referring facilities to choose the most appropriate facility for the care of their patients.
  • A training program was developed for all Emergency Medical Service providers to help them quickly recognize severe trauma and make the most appropriate destination decision.
  • A Trauma Care Assistance Revolving Fund was implemented in 1999 to reimburse hospitals and ambulance services for some of the costs of care of the severely injured patient. In the last reimbursement period, this fund had only $3.4 million to pay out, while there were $16.7 million in qualifying uncompensated care.

Earlier this year, the Oklahoma Legislature passed SB 621, which created the Task Force on Hospital Emergency Services and Trauma Care. The task force is reviewing the delivery of hospital emergency services and trauma care in Oklahoma. It must submit a report of its findings, including any recommendations for changes to existing statutory provisions related to hospitals and ambulatory surgical centers, to the legislature by Feb. 1, 2004.


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