Open AccessOrganizational network in trauma management in Italy
Author(s) -
Osvaldo Chiara,
Stefania Cimbanassi,
Alba Fava,
S. Vesconi
Publication year - 2005
Publication title -
emergency care journal
Language(s) - English
Resource type - Journals
eISSN - 2282-2054
pISSN - 1826-9826
DOI - 10.4081/ecj.2005.1.36
Subject(s) - medicine , christian ministry , medical emergency , multidisciplinary approach , trauma care , major trauma , emergency medicine , severe trauma , emergency medical services , traumatology , surgery , social science , philosophy , theology , sociology , orthopedic surgery
In Italy, as in other western countries, trauma is a leading cause of death during the first four decades of life, with almost 18.000 of deaths per year. Since 80s organized systems for trauma care, including a pre-hospital emergency medical system and a network of hospitals designated as Trauma Centres, have been developed in north American countries. Effectiveness of trauma systems has been investigated comparing the post-system to the pre-system trauma care with the method of panel evaluation of preventable death rates and comparison of observed survival with expected probability of survival. In Italy, a pre-hospital emergency medical system has been implemented on a national scale, while a trauma network has not been developed. Nowadays, trauma patients are often admitted to the closest hospital, independently from local resources. The Superior Council of Ministry of Health has presented in 2004 a new trauma system model (SIAT) based on the recognition in the field of patients with more serious injuries and the transportation to general hospitals with resources and multidisciplinary teams specialized in trauma care (trauma team). The designation of few trauma team hospitals, one highly specialized Centre (CTS) and two area Centres (CTZ) every two millions of inhabitants allows each Centre to treat at least 250 severe trauma patients per year to increase experience. Less severe injured patients may be treated in non-trauma team acute care facilities, according to the inclusive system model. The development of trauma team services in some Italian hospitals has demonstrated an increase in survival and a decrease in preventable death rate from 42% to 7,6%. Economic studies of Ministry of Health have established that the implementation of a trauma system model on a national scale with a 25% decrease of preventable trauma deaths and disabilities would save 7500 million of euros of public money. Therefore, in our country the concentration of severely injured patients in few well-equipped and specialized hospitals may be associated to better outcomes and decrease of social-costs