The first approach removed trauma centers, either singly or two at a time, from those in the existing Maryland Trauma System and then used TRAMAH to replace them with optimally located trauma centers.
When siting small numbers of resources, TRAMAH favors immediate coverage of the two high-volume clusters of severe injuries in the Baltimore County area and the metropolitan Washington, DC area.
The TRAMAH provides a mechanism for the periodic review of existing trauma care facilities, with a clearer process for designation, re-designation and de-designation (U.
This first application of TRAMAH was not necessarily intended to be an evaluation of Maryland, a state with a highly developed trauma system.
The TRAMAH has the computational flexibility to optimally locate various numbers of aeromedical depots and trauma centers, as separate resources or together, from a clean slate.
If the Maryland Trauma System relocated all eight of its aeromedical depots to sites optimally determined by TRAMAH, an additional 4,043 severely injured people could gain access to the trauma system within 15 minutes.
The TRAMAH contains three time parameters that could purposively be varied: ground travel, air travel, and global response times.
Future uses of TRAMAH in Maryland might constrain four trauma centers to Baltimore and then proceed to optimally site any additional trauma centers elsewhere in the state.