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Unnecessary Interfacility Transfers for Craniomaxillofacial Trauma
Matthew E Pontell1, Juan M Colazo1, Brian C Drolet1
1From the Department of Plastic Surgery and the Department of Biomedical Informatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center; and Vanderbilt University School of Medicine.
Plastic and Reconstructive Surgery
|April 26, 2020
Summary
Many craniomaxillofacial injury transfers are unnecessary, costing patients and healthcare systems significantly. Developing transfer guidelines can improve patient triage and reduce wasteful emergency interfacility transfers.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Health Services Research
Background:
- Craniomaxillofacial (CMF) injuries often necessitate interfacility transfers for specialized care.
- Current transfer guidelines are insufficient for CMF injuries, leading to unnecessary emergent transfers.
- Unnecessary transfers incur significant financial burdens on patients and the healthcare system.
Purpose of the Study:
- To assess the frequency and necessity of interfacility transfers for isolated craniomaxillofacial injuries.
- To identify patterns of unnecessary transfers in patients with facial trauma.
- To provide data for developing improved transfer guidelines for CMF injuries.
Main Methods:
- Retrospective review of interfacility transfers diagnosed with "facial trauma" between 2013 and 2018.
- Application of a validated framework to categorize transfers as necessary or unnecessary.
- Analysis of transfer outcomes, including admission rates and interventions.
Main Results:
- 368 transfers for isolated CMF injuries were identified.
- 50% of all transfers were deemed unnecessary.
- Only 27% of transferred patients required hospital admission; 3 required emergency surgery.
Conclusions:
- Isolated CMF trauma rarely necessitates emergency surgery, yet many transfers are unnecessary.
- Unnecessary transfers delay definitive care, increase healthcare costs, and strain resources.
- Implementing evidence-based transfer guidelines can optimize interfacility triage for facial trauma patients.
