The Model Trauma Care System Plan offers a framework for states to build trauma care systems once they have procured legislative authority.¹ In broad terms, the plan calls for states to link prehospital, acute care, and rehabilitation providers through leadership, systems development, planning, and evaluation, and through securing financing for system administration and patient care (HRSA, 1992). More specifically, the plan exhorts states to designate trauma centers, establish trauma registries, and ensure, in concert with communities, that triage and transport protocols are in place for the timely assessment and movement of patients to the most suitable acute care facility. Bazzoli and coworkers (1995) found that the most common problem for states was to limit the number of designated trauma centers based on community need. The ACS (1993) underscored the importance of states' limiting the number of designated centers for two primary reasons: (1) trauma teams must treat sufficient numbers of major trauma patients to maintain their expertise, and (2) unnecessary duplication of centers yields excessively high societal health care costs (see also Goldfarb et al. [1996]). The importance of maintaining sufficient patient volume as a determi-