Profile of Interfacility Emergency Department Transfers: Transferring Medical Providers and Reasons for Transfer. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Li, Joyce; Pryor, Stephanie; Choi, Ben; Rees, Chris A.; Senthil, Mamata V.; Tsarouhas, Nicholas; Myers, Sage R.; Monuteaux, Michael C.; Bachur, Richard G.
• Is Part Of: Pediatric emergency care. Volume 35:Issue 1(2019)
• Publication Date: 2019-01
• Subjects: health services research -- interfacility transfers -- transferring medical providers; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000000848
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Objectives: The aim of this study was to determine the reasons for pediatric emergency department (ED) transfers and the professional characteristics of transferring providers. Methods: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 tertiary care children's hospitals. Referring providers completed surveys detailing the primary reasons for transfer and their medical training. Results: The survey data were collected for 25 months, during which 641 medical providers completed 890 surveys, with an overall response rate of 25%. Most pediatric patients were seen by physicians (89.4%) with predominantly general emergency medicine training (64.2%). The median age of patients seen was 5.6 years. The 3 most common diagnoses were closed extremity fracture (12.2%), appendicitis (11.6%), and pneumonia (3.7%). The 3 most common reasons for transfer were need for medical/surgical subspecialist consultation (62.6%), admission to the inpatient unit (17.1%), and admission to the intensive care unit (6.5%). When asked about the need for supportive pediatric services, referring providers ranked pediatric subspecialty and pediatric inpatient unit availability as the highest. Conclusions: Most pediatric interfacility ED transfers are referred by general emergency medicine physicians who often transfer for inpatient admission or subspecialty consultation. Understanding the needs of the community-based ED providers is an important step to forming more collaborative efforts for regionalized pediatric emergency care. Abstract : Supplemental digital content is available in the text.