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Invited Commentary

Gerald O. Strauch, MD
Arch Surg. 1997;132(4):404. doi:10.1001/archsurg.1997.01430280078011.
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This study provides a succinct and refreshing view of the promise that can be expected in the provision of the highest level of medical care, unaffected by the level of reimbursement expected for that care, to seriously injured patients in a region served by an ethical and sophisticated trauma system. As is generally acknowledged, the HMC is one of the premier trauma centers in the United States, to which a 6.2% mortality rate for almost 3000 patients, from injuries that involve automobiles and with an average ISS of 14.6 per patient, readily attests.

Most gratifying to note was the improvement, during the 3 years of the study, in the 1 economic parameter studied that initially suggested bias within the system against the "NCI" bloc of patients, namely, the total hospital LOS among patients who were transferred to long-term care facilities. One may well ask, "How did this happen, and will


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