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Objective:

Provide a systematic review of the published literature assessing the affect of trauma center/system implementation on patient outcomes.

Data Sources:

A bibliographic search of MEDLINE (1966-May of 1998), HealthSTAR (1995-May of 1998), and CINAHL (1982-May of 1998). Additional manuscripts were identified in the references of reviewed manuscripts. Literature was limited to English language reports on trauma systems in the United States and Canada.

Study Selection:

Initial inclusion criteria were based on methodologic criteria (ie, a comparative [controlled] study). Authors independently assessed the strength of evidence demonstrated by each article.

Data Extraction:

Included articles were classified into three groups based on study design: panel review studies, trauma registry comparison studies, and population-based studies. Key demographic, sampling frame, study design, and outcome …