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Profiling Pediatric Potentially Avoidable Transfers Using Procedure and Diagnosis Codes.

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Potentially avoidable transfers (PATs) are common in pediatric patients, with over 30% discharged within 24 hours. Direct admissions had higher PAT rates, often for common conditions like respiratory infections.

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Area of Science:

  • Pediatric Healthcare
  • Healthcare Management
  • Patient Transfer Systems

Background:

  • Hospital transfers of pediatric patients are essential but can carry risks and costs.
  • Potentially avoidable transfers (PATs) represent a subset of transfers with high costs and safety risks but no clear benefit.
  • Understanding early discharges among transferred pediatric patients is crucial for improving care efficiency.

Purpose of the Study:

  • To describe pediatric interfacility transfers involving early discharges.
  • To identify characteristics of potentially avoidable transfers (PATs) within this patient group.

Main Methods:

  • A 12-month descriptive study using electronic medical record data from a single center.
  • Analysis of pediatric patients with a transfer admission source and early discharge (discharge within 24 hours).
  • Definition of PATs as transfers discharged home within 24 hours without specialized procedures or diagnoses.

Main Results:

  • 31.4% of 2,415 pediatric transfers were discharged within 24 hours.
  • 14.7% of transferred patients with early discharges (356 patients) were classified as PATs.
  • Direct admissions were 1.9 times more likely to be PATs than emergency department transfers.
  • Common PAT diagnoses included respiratory infections, asthma, and ill-defined conditions.

Conclusions:

  • Early discharges and PATs are frequent occurrences in pediatric interfacility transfers.
  • Further research is needed to understand the causes and clinical effects of PATs.
  • Direct admissions warrant focused investigation due to their high PAT rates in various intensive care units.