Inner-city trauma centers. Financial burdens or community saviors?

Trauma systems have proved effective in reducing morbidity and mortality rates. Depending on a center's geographic location and patient mix between penetrating and blunt trauma, participation in a system may be a liability or an asset. In general, inner-city hospitals tend to see more indigent patients and to have sizeable financial losses. At the same time, they provide an invaluable service to any community, and their ability to do so must be preserved. The two important issues of malpractice and uncompensated care threaten to destroy the very concept of trauma care and therefore pose a serious threat to the health care profession. Solutions are possible, but it will take a significant public awareness and education campaign to elicit the support and initiate the programs that will ensure that every injured patient has an opportunity to receive the best of trauma care. Inner-city hospitals are both a financial burden and a community savior.