Tertiary care hospitals

This includes hospitals with a broad range of subspecialties. Such facilities are usually, but not exclusively, teaching or university hospitals. They usually repre sent the highest level of care in a country or large political division within a country. There are notable differences in the capabilities of tertiary care hospitals worldwide. In some countries, surgical staff may be quite extensive in their range of subspecialties, and in others, more limited (Figure 1).

The manual does not make any recommendations regarding the optimum population served by each level of facility. However, this is of great relevance to the accessibility of trauma care by the population of a country. These issues are addressed by broader planning activities and should be considered by those planning trauma services for their country or area. Likewise, it is recognized that the different levels of facility will play differing roles within overall trauma treatment in different countries. For example, facilities staffed by non-doctors and hospitals staffed by general practitioners are likely to care for a greater percentage of all injured patients in low-income countries, whereas specialist-staffed hospitals and tertiary care hospitals are likely to care for a greater percentage of all injured patients in middle-income countries.

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