Profiling Interfacility Transfers for Hospitalized Pediatric Patients

Area of Science:

• Pediatric healthcare utilization
• Hospital administration
• Health services research

Background:

• Hospital-to-hospital transfers of pediatric patients are frequent but not well understood.
• Existing literature lacks comprehensive profiling of pediatric interfacility transfer characteristics.

Purpose of the Study:

• To profile pediatric interfacility transfers using a national database.
• To identify patient and hospital characteristics associated with transfer admissions.

Main Methods:

• Analysis of the 2012 Kids' Inpatient Database for pediatric patients (<21 years) with transfer admission source.
• Descriptive statistics to compare transfer vs. routine admissions.
• Multivariable logistic regression to identify factors associated with transfer admissions.

Main Results:

• 4.4% of pediatric hospitalizations were transfers; 9.4% excluding neonates.
• Transfers predominantly went to urban teaching hospitals (86%).
• Common transfer diagnoses included mood disorders, perinatal conditions, prematurity, asthma, and bronchiolitis.
• Factors associated with higher transfer odds: neonatal diagnosis, male gender, white race, nonprivate insurance, rural residence, higher illness severity, and weekend admission.

Conclusions:

• Interfacility transfers are a significant aspect of pediatric hospital care.
• Transfer likelihood is influenced by illness severity, principal diagnosis, insurance, and race.
• Further investigation is required to understand the causes and clinical effects of these transfer disparities.