Trends in Pediatric Hospitalizations Following Interfacility Transfer: 2009-2022

Area of Science:

• Pediatric Health Services Research
• Healthcare Systems Analysis
• Regionalized Care Models

Background:

• Pediatric care is increasingly regionalized, leading to more interfacility transfers.
• Rising pediatric admissions post-transfer may signal strain on healthcare systems.
• Evaluating nationwide trends in pediatric transfers is crucial for understanding system pressures.

Purpose of the Study:

• To evaluate nationwide trends in children admitted to hospitals following interfacility transfer.
• To analyze changes in the likelihood and costs associated with transferred-in pediatric admissions.
• To identify demographic and hospital-specific factors influencing pediatric transfer trends.

Main Methods:

• Retrospective analysis of the Kids' Inpatient Database (2009-2022).
• Logistic regression to assess longitudinal changes in transferred-in pediatric admissions.
• Stratification by hospital type, medical complexity, trauma presence, and diagnosis; cost analysis included.

Main Results:

• Overall pediatric admissions declined, but admissions following transfer increased by 7714 per year.
• The likelihood of a transferred-in admission rose by 5.7% annually across all hospital types.
• Transferred-in patient costs increased from 17.2% to 29.5% of total costs between 2009 and 2022.

Conclusions:

• Interfacility pediatric transfers and associated costs are rising, especially in rural hospitals and for non-medically complex children.
• Findings indicate an increasing reliance on patient transfers, necessitating enhanced local pediatric capacity.
• Improved regional care coordination is essential to manage the growing trend of pediatric interfacility transfers.