RT Journal Article SR Electronic T1 Evaluation of the Georgia trauma system using the American College of Surgeons Needs Based Assessment of Trauma Systems tool JF Trauma Surgery & Acute Care Open FD BMJ Publishing Group Ltd SP e000188 DO 10.1136/tsaco-2018-000188 VO 3 IS 1 A1 Dennis W Ashley A1 Etienne E Pracht A1 Laura E Garlow A1 Regina S Medeiros A1 Elizabeth V Atkins A1 Tracy J Johns A1 Colville H Ferdinand A1 Christopher J Dente A1 James R Dunne A1 Jeffrey M Nicholas A1 , YR 2018 UL http://tsaco.bmj.com/content/3/1/e000188.abstract AB Background The American College of Surgeons Needs Based Assessment of Trauma Systems (NBATS) tool was developed to help determine the optimal regional distribution of designated trauma centers (DTC). The objectives of our current study were to compare the current distribution of DTCs in Georgia with the recommended allocation as calculated by the NBATS tool and to see if the NBATS tool identified similar areas of need as defined by our previous analysis using the International Classification of Diseases, Ninth Revision, Clinical Modification Injury Severity Score (ICISS).Methods Population counts were acquired from US Census publications. Transportation times were estimated using digitized roadmaps and patient zip codes. The number of severely injured patients was obtained from the Georgia Discharge Data System for 2010 to 2014. Severely injured patients were identified using two measures: ICISS<0.85 and Injury Severity Score >15.Results The Georgia trauma system includes 19 level I, II, or III adult DTCs. The NBATS guidelines recommend 21; however, the distribution differs from what exists in the state. The existing DTCs exactly matched the NBATS recommended number of level I, II, or III DTCs in 2 of 10 trauma service areas (TSAs), exceeded the number recommended in 3 of 10 TSAs, and was below the number recommended in 5 of 10 TSAs. Densely populated, or urban, areas tend to be associated with a higher number of existing centers compared with the NBATS recommendation. Other less densely populated TSAs are characterized by large rural expanses with a single urban core where a DTC is located. The identified areas of need were similar to the ones identified in the previous gap analysis of the state using the ICISS methodology.Discussion The tool appears to underestimate the number of centers needed in extensive and densely populated areas, but recommends additional centers in geographically expansive rural areas. The tool signifies a preliminary step in assessing the need for state-wide inpatient trauma center services.Level of evidence Economic, level IV.