Pediatric Conditions Requiring Minimal Intervention or Observation After Interfacility Transfer

Area of Science:

• Pediatric Healthcare
• Healthcare Systems Analysis
• Patient Transfer Management

Background:

• Regionalization of pediatric care increases interfacility transfers for general pediatric conditions.
• Transfer rates for these children approach those of high-risk adults, potentially delaying treatment.

Purpose of the Study:

• Identify common pediatric diagnoses requiring minimal advanced intervention.
• Determine diagnoses with high rates of discharge within 1 day post-transfer.
• Inform strategies for building pediatric capacity in non-pediatric facilities.

Main Methods:

• Utilized the Pediatric Health Information System (PHIS) database for 2019 transfers.
• Excluded mental health, labor/maternity, newborn, and direct ICU admissions.
• Categorized eligible encounters by hospitalization duration and intervention level.

Main Results:

• Analyzed 197,386 eligible transfers (68.6% of total).
• Cough, febrile seizures, croup, and allergic reactions required advanced interventions in <10% of cases.
• These conditions showed the highest rates of discharge within 1 day post-transfer.

Conclusions:

• Cough, febrile seizures, croup, and allergic reactions are suitable targets for developing pediatric capabilities in non-pediatric hospitals.
• Optimizing care for these common conditions can reduce unnecessary transfers and improve efficiency.
• Enhancing local capacity can mitigate delays in appropriate treatment for transferred pediatric patients.