Trauma system development: the critical need for regional needs assessments.

Americans presume trauma center expertise exists for patients with major injuries. Although concentrated expertise exists for cancer and cardiovascular diseases, such expertise for trauma exists only in a disappointingly small portion of the country. The deficiency of trauma systems persists despite more than 2 decades of published data demonstrating effectiveness with a reduced rate of death and disability.1 The Skamania Conference provided an important and timely summary of supporting evidence for trauma systems effectiveness and highlighted many potential reasons why certain areas of the country still lack trauma systems.2 One reason, which I would like to develop further, is the importance of a timely, objective needs assessment.