Emergency Transfers Are Associated With Increased Financial Charges

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.