Hospitals with Pediatric Trauma Capability Are Often Bypassed in California

In a retrospective analysis of pediatric trauma patients (age, ≤18 years) who were transferred to a single adult level I trauma center with a pediatric intensive care unit (PICU) in California, investigators identified predictors of bypassing other pediatric-capable trauma hospitals. A pediatric-capable hospital was defined as a pediatric trauma center, an adult level I or II trauma center with a PICU, a nontrauma center with a PICU, and, for patients ages 15 to 18 years, a level I adult trauma center.

Of 2798 pediatric trauma patients who were admitted to the study site between 2000 and 2007, 454 (16%) were transferred from other facilities. Median transfer distances were significantly longer for patients with public or no insurance than fo…