Access to Pediatric Trauma Centers: Current Status and Opportunities for Improvement

Evidence suggests that timely treatment at trauma centers with high pediatric readiness improves survival rates for children, yet access to such care has not been evenly distributed geographically. Significant efforts have been made to enhance pediatric readiness across the country, including the establishment of new standards for emergency departments at trauma centers.

The present study aimed to evaluate the current access to pediatric-ready trauma center care in the developed country and to estimate how access could improve if all high-level trauma centers achieved optimal pediatric readiness.

This descriptive cross-sectional study gathered data on trauma centers from various national and state sources, conducting a geospatial analysis of access for pediatric patients (aged ≤18 years) to trauma centers within 60 minutes, based on trauma center type and pediatric readiness. The key outcome was access to pediatric-ready trauma centers, defined as high-level pediatric (level I-II) or adult trauma centers (level I-III) with a wPRS of at least 93. Access times were calculated using validated methods and service network model analysis.

The outcome demonstrated:

• The analysis encompassed 148 pediatric and 1,075 high-level adult trauma centers, with 273 adult centers (25%) deemed pediatric ready. 
• Access to pediatric trauma centers within 60 minutes via ground or air ambulance was available for 65% of the 74,090,665 children studied.
• Moreover, 73% had access to a pediatric-ready trauma center within this timeframe, while 92% could reach any high-level trauma center within 60 minutes.

To summarize, results showed that access to pediatric trauma center care remains limited, even with air transport. Increasing pediatric readiness at all high-level adult trauma centers could significantly enhance access to timely and quality trauma care for children.

Source: Melhado C, Hancock C, Wang H, et al. Pediatric Readiness and Trauma Center Access for Children. JAMA Pediatr. Published online February 03, 2025. doi:10.1001/jamapediatrics.2024.6058