Emergency Department Interfacility Transfers Requiring Critical Procedures are Increasing: A United States Nationwide...

Area of Science:

• Healthcare Management
• Emergency Medical Services (EMS)
• Patient Transfer Protocols

Background:

• Post-COVID-19 pandemic healthcare shifts led to reduced hospital services and increased interfacility transfers.
• Managing critically ill patients, especially after invasive procedures, demands specialized emergency medical services (EMS) training and resources.
• The complexity of patient care during transfers necessitates a closer look at current EMS capabilities.

Purpose of the Study:

• To quantify and analyze trends in interfacility transfers of patients who underwent critical procedures in US emergency departments (EDs).
• To examine the period from 2018 to 2022 for changes in the volume and nature of these transfers.
• To establish a baseline for future research and policy development in EMS patient management.

Main Methods:

• Retrospective cross-sectional study utilizing the 2018-2022 Nationwide Emergency Department Sample (NEDS) datasets.
• Included adult patients (≥18 years) transferred between short-term hospitals, focusing on those undergoing critical procedures (e.g., intubation, ventilation, central line insertion).
• Weighted analyses were performed to account for the complex survey design, calculating counts and confidence intervals (CIs).

Main Results:

• Over 9.8 million adult patients were transferred from US EDs between 2018-2022.
• Approximately 6.6% (655,442 patients) of transferred patients had undergone at least one critical procedure.
• A significant positive trend (OR 1.09) was observed in interfacility transfers involving critical procedures over the study period, excluding pacing procedures.

Conclusions:

• The increasing volume of interfacility transfers involving critical procedures necessitates greater investment in EMS resources and specialized training.
• Current EMS systems face escalating demands in managing complex patient needs during interfacility transports.
• This trend underscores the importance of adapting EMS protocols and capabilities to evolving healthcare demands.