Even though Cook County, Ill., has 19 trauma centers, roughly one-third of gunshot wounds in the county from 2009 to 2013 were treated outside of designated trauma centers, according to a study published by JAMA Surgery.
Researchers examined the prevalence, geographic distribution and clinical outcomes of victims of firearm-related injuries of residents of Cook County from 2009 to 2013 using outpatient and inpatient hospital databases.
They included 9,886 patients in the analysis and found 29 percent of patients with firearm-related injuries were initially treated in a facility not designated as a trauma center.
When a patient has a gunshot wound near the elbow or knees, guidelines recommend bypassing nearby hospitals to access a specialized trauma unit. The study found 18 percent of patients with that type of injury were still treated in a nondesignated facility, and only 10 percent of those were transferred to a designated trauma facility.
Undertriage was sustainably more common in certain neighborhoods on the West Side of Chicago and the southern areas of Cook County and Chicago.
"This study highlights the need for better regional coordination, especially with interhospital transfers, as well as the importance of assessing the distribution of emergency medical services resources to make the trauma care system more effective and equitable," the study's authors wrote.