Resource Utilization for Pediatric Patients Discharged After Interhospital Transfer

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Systems Analysis
• Transfer Medicine

Background:

• Optimizing patient transfers to pediatric emergency departments (PEDs) from general emergency departments (EDs) is crucial.
• Understanding resource utilization in PEDs for transferred patients informs educational and resource needs in general EDs.

Purpose of the Study:

• To compare resource utilization in a pediatric emergency department (PED) for patients transferred from academic versus community general emergency departments (EDs).
• To identify differential educational and resource needs within general EDs based on transfer patterns to a PED.

Main Methods:

• Retrospective review of patients under 21 years old transferred to a PED and discharged home over one year.
• Categorization of referring institutions as academic or community EDs.
• Comparison of demographic and clinical variables, including resource utilization, between academic and community ED referrals.

Main Results:

• Of 5675 interfacility transfers, 1603 (28.2%) were discharged from the PED.
• Most patients (67.4%) originated from community EDs.
• Patients from community EDs had higher rates of procedures (44% vs 39%) and high resource utilization (61% vs 55%) in the PED compared to those from academic EDs, with no significant differences in laboratory testing, ancillary studies, or medication administration.

Conclusions:

• The majority of children transferred to a PED from general EDs require minimal resources prior to discharge.
• Differences in care patterns between academic and community ED referrals highlight distinct educational and resource requirements for general EDs managing pediatric patients.