• Koen Van den Heede, Cécile Dubois, Patriek Mistiaen, Sabine Stordeur, Audrey Cordon, and Marie Isabel Farfan-Portet.
• Belgian Healthcare Knowledge Centre, Kruidtuinlaan 55, 1000, Brussels, Belgium. Koen.vandenheede@kce.fgov.be.
• Eur J Trauma Emerg Surg. 2019 Oct 1; 45 (5): 885-892.

PurposeIn light of the international evolutions to establish inclusive trauma systems and to concentrate the care for the most severely injured in major trauma centres, we evaluated the degree of dispersion of trauma care in Belgium.MethodsWe used descriptive statistics to illustrate the dispersion of major trauma care in Belgium based on two independent administrative databases: the registry of Mobile Intensive Care Units (2009-2015) and the Belgian Hospital Discharge Dataset (2009-2014).ResultsPatients with a severe trauma (n = 3856 in 2015) were transported towards 145 different hospital sites (on a total of 198 hospital sites) resulting in a median of 17 cases per hospital site (min = 1; P25 = 4; P75 = 30; max = 165). A minority of major trauma patients is after admission transferred to another hospital (8%) with a median of 10 days after admission to the hospital (IQR 3.5-24).ConclusionsThe dispersion of care for major trauma patients in Belgium is so high that a reorganisation of care for severe injured patients in major trauma centres concentrating professional expertise and specialised equipment is recommended to guarantee a high quality of care in a qualitative and sustainable way.

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