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Emergency Transfers Are Associated With Increased Financial Charges.

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Pediatric emergency transfers (ETs) significantly increase hospital charges for children. Investing in systems to prevent these unplanned intensive care unit (ICU) transfers is crucial for both clinical and financial reasons.

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Area of Science:

  • Pediatric critical care medicine
  • Healthcare economics
  • Hospital administration

Background:

  • Pediatric emergency transfers (ETs) are unplanned intensive care unit (ICU) transfers requiring immediate critical interventions.
  • ETs are linked to increased mortality and prolonged hospital stays.
  • The financial implications of pediatric ETs remain largely unquantified.

Purpose of the Study:

  • To compare the post-transfer financial charges associated with pediatric emergency transfers (ETs) versus non-ETs.
  • To determine the economic burden of ETs in a pediatric hospital setting.

Main Methods:

  • A retrospective cohort study analyzed 2034 ICU transfers from 2015-2019 at a children's hospital.
  • Compared aggregate and daily post-transfer charges (ICU and total hospital) between ETs and non-ETs.
  • Adjusted for patient factors (age, chronic conditions) and transfer characteristics (LOS, service, deterioration type) using regression models.

Main Results:

  • ETs were associated with significantly higher unadjusted and adjusted post-transfer charges.
  • Adjusted increases in charges for ETs were 65% for ICU, 49% for total hospital stay, and 20% daily.
  • Charge increases varied by originating service and type of deterioration, with respiratory ETs showing the highest cost increase.

Conclusions:

  • Pediatric emergency transfers (ETs) represent a substantial financial burden on hospitals.
  • The findings underscore the economic necessity of implementing preventative strategies to reduce ETs.
  • Reducing ETs can yield significant cost savings alongside improved patient outcomes.