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Statewide Trauma System Drawing Support

LITTLE ROCK -- Arkansas hospital officials voiced support Monday for a statewide trauma system to coordinate emergency care but warned such a system would have to be well coordinated and well funded to work.

"We are interested, but I think it needs to be a very well thought out system, and there needs to be enough funding or else we're wasting our time," Bob Atkinson, chief executive officer of Jefferson Regional Medical Center in Pine Bluff, told legislators.

The cost of establishing such a system in Arkansas is estimated at $28 million to $35 million, said Dr. Joe Thompson, the state's surgeon general.

Legislators will consider a proposal for a statewide trauma system during the 2009 session, which starts in January.

Legislation for a trauma system failed last year when the House and Senate deadlocked over how to pay for it.

Atkinson was one of five hospital officials from around the state who spoke at a joint meeting Monday of the Arkansas Legislative Council's Hospital and Medicaid Study Subcomittee and the House and Senate Committees on Public Health, Welfare and Labor in anticipation of next year's proposal.

Traumais any sudden, serious injury from an external force, such as a car accident, electric shock or gunshot wound.

There were 25,308 hospitalizations in Arkansas from trauma in 2005, or about 70 a day, according to the latest data from the state Health Department. That same year, 2,119 people in the state died from trauma.

That's about six deaths per day, said Paul Halverson, director of the Arkansas Department of Health.

Having a trauma system would save about 200 to 600 lives and $193 million a year because it would ensure emergency responders get patients to facilities capable of treating their injuries as quickly as possible, he said.

Many more would be saved from debilitating injuries because they would get specific care faster, Halverson said.

The state has several options for funding a trauma system, Thompson said. Those include finding a way to enforce a state law that requires drivers to have car insurance, which would mean increased revenues from medical fees already included in insurance rates, he said. Legislators could increase license and car tag fees, raise a 911 surcharge on phone bills, or have hospitals or nursing homes pay special provider fees, Thompson said.

State Rep. Gene Shelby, D-Hot Springs, said he's considering introducing legislation to increase Arkansas' cigarette tax by about 50 cents per pack. The state's cigarette tax is now 59 cents per pack, below the national average of $1.14 per pack.

But Shelby said he anticipates any form of tax increase will be a hard sell during the 2009 session, because of the ailing economy.

"The whole sentiment is going to be a lot different this session," Shelby said. "There's going to be a lot of competing interests." State Sen. Tracy Steele, D-North Little Rock, said he would like to see some of the funding come from general revenue, even if it means cutting funding somewhere else.

"We're going to have to look at several different incidences," he said.

With a trauma system, emergency responders would be able to tap immediately into a computer system - called a "dashboard" - that would show them quickly which hospitals in the region had what emergency services and specialists available at that moment, Atkinson said.

Under the current system, emergency responders or hospital personnel have to call individual hospitals to get that information. Saving time is crucial when dealing with patients with multiple injuries who need care as quickly as possible, he said.

"A trauma system is merely a communications system that is not existent in this state right now," said Jamie Carter, chief executive officer of Crittenden Regional Hospital in West Memphis.

The money would be used to pay for the system and training for emergency personnel and to help hospitals provide incentives for doctors to be on call to provide trauma care.

Carter, who also volunteers as an emergency responder, said he knows what it's like to be on the phone trying to find a hospital to treat a patient who needs immediate care.

"I spend 15 minutes on a phone trying to find a receiving hospital, and that's after I've spent 30 minutes cutting a victim out of a vehicle," he said. "As a state we are tripping over ourselves right now because we don't have that coordination right now." Timothy E. Hill, chief executive officer of North Arkansas Regional Medical Center in Harrison, cited a case in which it took nearly an hour and 45 minutes to get a patient with a gunshot wound to the face from Deer in Newton County to a hospital in Springfield, Mo., because officials had to call multiple facilities to determine who could best treat the patient.

"Had we had that [trauma] system, it would be much faster," Hill said.

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