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Interfacility Transfers Among Patients With Complex Chronic Conditions.

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Interfacility transfer for children with complex chronic conditions (CCCs) is common and associated with worse outcomes. Transferred children experienced longer hospital stays, increased critical care, and higher mortality rates.

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Area of Science:

  • Pediatric Healthcare
  • Health Services Research
  • Chronic Illness Management

Background:

  • Interfacility transfers are common for children with complex chronic conditions (CCCs).
  • The impact of these transfers on health outcomes requires thorough investigation.

Purpose of the Study:

  • To describe interfacility transfer patterns in pediatric CCC hospitalizations.
  • To determine the association between interfacility transfer and key health outcomes.

Main Methods:

  • Retrospective cohort study using the 2012 Kids' Inpatient Database.
  • Identification of CCC hospitalizations using ICD-9 codes.
  • Statistical analysis (quasi-Poisson and logistic regression) to assess transfer impact on length of stay, critical care, and mortality.

Main Results:

  • 13% of pediatric CCC hospitalizations involved interfacility transfer.
  • Transferred patients had a 1.6x longer length of stay.
  • Transferred patients were 3x more likely to receive critical care and 3.6x more likely to experience in-hospital mortality.

Conclusions:

  • Interfacility transfer is a significant factor in pediatric CCC hospitalizations.
  • Transfers are associated with increased length of stay, critical care utilization, and mortality.
  • Further research into clinical and logistical factors influencing transfer outcomes is warranted.