We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Should Regionalization Only Be in 1 Direction?

Michael E. Zenilman, MD1,2
[+] Author Affiliations
1National Capital Region, Johns Hopkins Medicine, Suburban Hospital, Bethesda, Maryland
2SUNY Downstate School of Public Health, Brooklyn, New York
JAMA Surg. 2014;149(4):327-328. doi:10.1001/jamasurg.2013.4861.
Text Size: A A A
Published online


The article by Matsushima et al1 gives a new perspective on regionalization of care for trauma. In elderly patients who have been treated at level 1 and level 2 trauma centers in Pennsylvania, the authors noted a 25% decrease in mortality for those at centers that treat more than 100 geriatric patients annually. These high-volume geriatric trauma centers have lower rates of major complications, even lower incidences of failure to rescue after a major complication when compared with centers with fewer than 100 such patients annually. Conversely, at institutions that have larger numbers of nongeriatric trauma patients, there was a significantly higher rate of major complications for elderly individuals.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment
Regionalization of Health Care
Posted on January 24, 2014
Lawrence A. Danto, MD FACS
UC Davis
Conflict of Interest: None Declared
Regionalization is not just an effective method for trauma care; but an effective method for producing positive outcomes concerning all complex health care issues. Regionalization of care is possibly the hallmark of a national healthcare system. Get our patients where they need to go!
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Should regionalization only be in 1 direction? JAMA Surg 2014;149(4):327-8.
Performance of a regional trauma network: A state-wide analysis. J Trauma Acute Care Surg 2016;81(1):190-5.