The impact of trauma, or injury, on society is profound. Trauma is the leading

cause of years of potential life lost and the fourth leading cause of death in the United States. Trauma causes more than 150,000 deaths annually. Each year, 57 million Americans are injured -1 in 4 seriously enough to require medical treatment. Nonfatal injuries account for 1 in 6 hospital days and for 1 in 10 hospital discharges ( 1 ). Trauma and its adverse outcomes occur disproportionately among young and elderly persons, who have special trauma care needs. Among children and adolescents 1-19 years of age, trauma causes more deaths than all diseases combined (2 ). Trauma, including intentional and unintentional injuries, takes a large toll on our society in terms of death, morbidity, and disability. Trauma creates huge problems in lost productivity and medical care costs. In 1985, the overall cost of trauma was estimated at $158 billion (1 ). That same year, trauma cost the federal government $21.7 billion. This figure includes $8.9 billion in direct medical payments and $12.8 billion in disability and death payments (1 ). Trauma care systems can play a vital role in reducing mortality, morbidity, and disability due to injuries. The optimal trauma care system is designed to care for all injured patients and provides a continuum of services including: prevention programs, prehospital care, acute care, and rehabilitation. In this summary, this type of system is called an inclusive trauma care system. A small subset of patients are major trauma patients with life-threatening injuries. Optimal care for these patients will require the resources of highly specialized institutions called trauma centers. Trauma care systems that treat the most severely injured patients improve patient outcome (3-10 ). Because nonfatal, traumatic injury has a major impact on the young, effective trauma care systems can play a key role in rapid recoveries for these people. To address the needs of all injured patients, inclusive trauma care systems that involve all acute care facilities are needed to have a truly comprehensive and cost-effective system. More importantly, the constant surveillance of injuries by trauma systems would allow identification of high-risk groups and injury problems. In