A population-based survival assessment of categorizing level III and IV rural hospitals as trauma centers.

Context: Patients injured in rural areas are hypothesized to have improved outcomes if statewide trauma systems categorize rural hospitals as Level III and IV trauma centers, though evidence to support this belief is sparse.

Purpose: To determine if there is improved survival among injured patients hospitalized in states that categorize rural hospitals as trauma centers.

Methods: We analyzed a retrospective cohort of injured patients included in the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 1997 to 1999.