Related Experiment Video
Updated: Sep 27, 2025
Author Spotlight: A Multi-Depth Porcine Model for Comprehensive Study of Burn Injuries and Healing Processes
Published on: February 23, 2024
Social Work Evaluations Among Pediatric Patients Transferred for Burn Care
Alyssa M Barré1, Lauren A Tyler1, Marvin A Rhodes2
1RinggoldID:368074University of South Carolina School of Medicine Greenville, Greenville, SC, USA.
Insights
Regionalization of pediatric burn care did not show disparities based on race or insurance. However, significant gaps in social work evaluation and record access were identified, impacting patient care.
Area of Science:
- Pediatric Surgery
- Burn Care Management
- Healthcare Regionalization
Background:
- Regionalization aims to enhance healthcare delivery by establishing specialized centers.
- The impact of regionalization on pediatric burn patient treatment and outcomes requires further investigation.
- Potential influences of patient demographics and socioeconomic factors on regionalization processes are hypothesized.
Purpose of the Study:
- To evaluate the impact of regionalization on pediatric burn patient transfers.
- To identify potential disparities in transfer rates based on race, socioeconomic status, and insurance.
- To assess the adequacy of social work involvement and record accessibility in the regionalization process.
Main Methods:
- Retrospective review of 81 pediatric patients (0-18 years) evaluated at a Level 2 Trauma Center.
- Data collected from February 2016 to December 2020 for patients meeting transfer criteria to a Regional Burn Center.
- Analysis included demographic, socioeconomic, insurance, and follow-up data.
Main Results:
- 67% of pediatric burn patients were transferred to a Regional Burn Center, with no demographic or insurance-based disparities observed.
- Over 57% of transferred children lacked social work evaluation, including cases of non-accidental trauma (NAT).
- Incomplete burn center records were noted in 67% of transferred patients without social work evaluation, particularly in NAT cases.
Conclusions:
- Pediatric burn patient transfer rates in regionalized systems show no disparities related to race, ethnicity, or insurance.
- Significant gaps exist in social work evaluation and inter-center record accessibility for pediatric burn patients.
- Policy recommendations are needed to address social concerns and ensure comprehensive care during regionalization.
Introduction:
Regionalization efforts aim to improve healthcare by designating specialty centers for a geographic area. Regionalization may play a role in determining patient treatment plans and outcomes. We hypothesize that these factors may be influenced by race, socioeconomics, insurance, and longitudinal follow-up.
Methods:
Retrospective review of 81 patients ages 0-18 years evaluated at our Level 2 Trauma Center between February 2016-December 2020 who met criteria for transfer to a Regional Burn Center.
Results:
67% of patients were transferred to the Regional Burn Center. There was no difference in the percentage of transferred patients with respect to age, race, ethnicity, insurance type, or rurality of home address. Secondary analysis showed that 57.4% of children were transferred without evaluation by social work. Five patients' injuries were due to non-accidental trauma (NAT); two of these patients were transferred without social work evaluations. 28% of those transferred had documented involvement of Child Protective Services (CPS). Of the 31 transferred patients without social work evaluation, 67% had incomplete or missing notes from the burn center, including 100% of those subsequently confirmed to be due to NAT. Only 32% of patients received follow-up at our institution.
Conclusion:
We identified no differences in transfer percentages with respect to race, ethnicity, or insurance type. Secondary analysis demonstrated a significant gap in care regarding access to records and social work involvement. As NAT and social concerns are common amongst children with burns, we propose policies to ensure that these concerns are not overlooked during regionalization efforts.
Related Concept Videos
01:15Nursing Evaluation
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:16Kidney Transplant III: Nursing Management
01:20Acute Kidney Injury V: Interprofessional Care
01:20Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...