Background: This study compares the preventable death rate and the nature and degree of inappropriate care in a rural state before and after implementation of a voluntary trauma system.
Methods: Deaths attributed to mechanical trauma occurring in the state of Montana between January 1, 1998, and December 31, 1998, were retrospectively reviewed by a multidisciplinary panel of physicians and nonphysicians representing the hospital and prehospital phases of care. Deaths were judged frankly preventable, possibly preventable, and nonpreventable.