To the Editor: We are delighted by the publication of Hoffer's review of emergency medical services in Massachusetts, but we are bothered by his unwillingness to endorse categorical referral of injured patients to appropriate hospitals.1 Without citing any of the “less solid” evidence, he surprisingly dismisses the value of the categorical trauma center as not yet demonstrated. Frey et al. have reviewed studies supporting immediate transfer of severely injured patients to institutions staffed and equipped for comprehensive emergency care.2 Such categorical referral of trauma patients improves their chances of survival. West et al. have demonstrated the deficiencies of nonregionalized.
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