Cobb A B
Mississippi Department of Health, Jackson.
J Miss State Med Assoc. 1991 Mar;32(3):87-8.
The need for planning and development of statewide trauma prevention and trauma service systems is or should be a high priority--if one sets priorities on criteria that address important factors such as cost to benefits in reduction of life years lost and reduction of disability and costs of long-term rehab services, etc. Prevention of injury and first class trauma care will lessen our heavy human burdens (loss of life and disability) and reduce our long-term outlays for rehabilitation, etc. Obviously our first line of intervention should be prevention--all educational, regulatory and automatic protectors (seat belts, gun restrictions, air bags) that will lower injury rates. A state trauma system must be planned for the larger universe than individual institutions or communities. We must educate our public that the only practical way to provide services for major trauma is through regionalized systems that they somehow must help support. The recent emphasis on making the health services industry a "competitive market" has discouraged public interest and support for regionalized health systems. Our best chances for funding such systems are probably through user fees, sin taxes and surcharges on fines, etc. We need the elements or principles of a plan and present it to the public and to their representatives in the courthouses, city halls and state capital of our state. We need to generate public discussion and understanding on the problem, the potential for saving lives and preventing disability. To do any less would mean our failure to meet our duties as health professionals and public health officials.
规划和发展全州范围的创伤预防及创伤服务系统的需求是或应当是高度优先事项——前提是依据诸如减少生命年损失、降低残疾率以及减少长期康复服务成本等效益方面的重要因素来设定优先事项。预防伤害和提供一流的创伤护理将减轻我们沉重的人力负担(生命损失和残疾),并减少我们在康复等方面的长期支出。显然,我们的第一道干预防线应该是预防——所有能够降低伤害率的教育、监管和自动保护装置(安全带、枪支限制、安全气囊)。一个州的创伤系统必须针对比个别机构或社区更大的范围来规划。我们必须教育公众,为重大创伤提供服务的唯一可行途径是通过区域化系统,而他们必须以某种方式予以支持。最近将医疗卫生服务行业打造成“竞争市场”的做法削弱了公众对区域化卫生系统的兴趣和支持。为这类系统筹集资金的最佳机会可能是通过使用费、罪孽税和罚款附加费等。我们需要一个计划的要素或原则,并将其呈现给公众以及他们在我们州的法院、市政厅和州议会大厦的代表。我们需要引发公众对这一问题、拯救生命和预防残疾潜力的讨论与理解。不这样做将意味着我们未能履行作为卫生专业人员和公共卫生官员的职责。