Background: Two previous reports, in 1987 and 1993, have tracked trauma system development in the United States. This report updates the current status of trauma systems in the United States. Methods: All state emergency medical service directors (including the District of Columbia) were surveyed regarding the existence of trauma systems in their states, including the presence of eight essential criteria of trauma system development that have been the focus of the two previous studies. Data were analyzed and compared with results previously published in the two reports. Results: Five states met all eight essential development criteria, 28 states met six or seven criteria, and another 10 states met between one and five criteria. In the 1993 study, 18 states met six or more criteria. In 1987, 22 states reported meeting four or more criteria. Conclusion: There has been significant progress, when compared with 1987 and 1993 evaluations in the number of states reporting the presence of trauma systems and meeting six or more key criteria. Recent progress may be due to federal assistance for trauma system development available from 1991 until 1995.
