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Hospital size impacts adherence to American Burn Association (ABA) referral guidelines. Larger hospitals more frequently follow ABA criteria and admit burn patients, improving care efficiency.

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Area of Science:

  • Trauma Surgery
  • Healthcare Management
  • Public Health

Background:

  • Burn centers are essential for optimal burn injury management, necessitating timely patient referral.
  • The American Burn Association (ABA) established referral criteria to guide healthcare providers.
  • Variable adherence to ABA guidelines affects resource allocation and patient outcomes.

Purpose of the Study:

  • To evaluate how hospital size influences adherence to ABA referral guidelines.
  • To analyze the impact of hospital size on burn patient referral patterns and outcomes.
  • To identify strategies for improving burn care referral efficiency.

Main Methods:

  • Retrospective review of 588 telephone inquiries to a state burn center (January 1 - December 31, 2024).
  • Analysis of data including hospital size (beds), ABA guideline adherence, and patient disposition (admission, ED referral, outpatient).
  • Statistical analysis using chi-square tests to determine significance (p < 0.05).

Main Results:

  • Larger hospitals (≥300 beds) accounted for 29% of inquiries and had a 34% admission rate.
  • Smaller hospitals (<100 beds) represented 36% of calls with only a 20% admission rate.
  • Larger hospitals demonstrated higher ABA guideline adherence (72%) compared to smaller hospitals (25%, p=0.02).
  • Referrals from larger hospitals were significantly more likely to result in admission (1.7 times more than smaller hospitals, p < 0.005).

Conclusions:

  • Hospital size is a significant determinant of adherence to burn care referral guidelines.
  • Larger hospitals exhibit better guideline compliance and higher patient admission rates.
  • Implementing telehealth, education, and outreach can enhance referral efficiency and optimize burn care delivery.