Impact of regulatory and epidemiological changes on trauma care in children and adolescents in Chile

Abstract

Chile has undergone significant demographic and epidemiological changes impacting healthcare for children and adolescents, particularly in trauma care. In 2025, the Ministry of Health extended the pediatric age limit to 18 years, aligning with international recommendations.

Objective: To analyze the impact of changes in trauma care from an epidemiological and economic evaluation perspective.

Methods: Retrospective descriptive study based on open-access data from the Department of Health Statistics and Information (DEIS), the National Institute of Statistics (INE), and the Office of the Ombudsman for Children’s Rights. Hospital discharge data, trauma causes, mortality, and current legislation were analyzed and interpreted according to CHEERS criteria.

Results: The extension of the pediatric age limit led to an increase of nearly 30% in the population assigned to pediatric services. Additionally, the projected annual economic impact exceeded CLP 635 billion. Concurrently, a sustained increase in trauma-related hospital discharges among adolescents was observed, with a higher frequency of injuries associated with interpersonal violence, self-inflicted injuries, and high-energy accidents.

Conclusions: Extending the pediatric age limit poses a challenge for the training of Surgeons and Pediatricians involved in trauma care and calls for restructuring adolescent trauma management through specific training, updating protocols, and budget planning. A National Pediatric Trauma Network is proposed, with stratified centers, integration with Emergency Medical Services, and a mandatory registry, aiming to promote quality, equity, and continuity of care.