+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Characteristics of Pediatric Patient Transferred From Hospital-Based General Emergency Departments to Acute-Care Facilities: An Analysis of the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample



Characteristics of Pediatric Patient Transferred From Hospital-Based General Emergency Departments to Acute-Care Facilities: An Analysis of the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample



Pediatric Emergency Care 2018:



The objective of this study was to analyze the characteristics of pediatric patients transferred from a hospital-based general emergency department (ED) to an acute care facility. Study data were abstracted from the 2010 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database. A multivariate logistic regression was constructed for pediatric patients (<18 years old) who require a transfer to an acute care facility from a general ED. Independent variables included in the model were age (<1, 1-4, 5-9, 10-14, 15-17 age in years), sex, insurance/payment method, and diseases/body systems using International Classification of Diseases, Ninth Revision, coding. In the Healthcare Cost and Utilization Project/Nationwide Emergency Department Sample, 5.5 million ED visits were for children less than 18 years. About 1.5% of visits resulted in transfer. Children younger than 1 year had higher transfer rates as compared with 15 to 17 year old group (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.089-1.146). Patients with Medicaid and self-pay compared with private insurance/health maintenance organization had 4% (OR, 0.96; 95% CI, 0.944-0.976) and 9% (OR, 0.91; 95% CI, 0.886-0.945), respectively, lower likelihood of being transferred. Patients with circulatory (OR, 8.43; 95% CI, 7.8-9.1), endocrine (OR, 5.9; 95% CI, 5.6-6.2), mental (OR, 5.44; 95% CI, 5.3-5.6), nervous system (OR, 5.2; 95% CI, 4.9-5.5), congenital anomalies (OR, 5.14; 95% CI, 4.5-5.9), hematology-oncology (OR, 4.49; 95% CI, 4.2-4.8), digestive, (OR, 1.52; 95% CI, 1.5-1.6), and other disorders (OR, 1.33; 95% CI, 1.3-1.4) had a higher odds of being transferred as compared with trauma/injury and poisoning, whereas patients with disorders related to genitourinary (OR, 0.96; 95% CI, 0.91-1.0), respiratory (OR, 0.79; 95% CI, 0.77-0.81), musculoskeletal (OR, 0.63; 95% CI, 0.58-0.68), skin (OR, 0.47; 95% CI, 0.45-0.50), infectious and parasitic (OR, 0.23; 95% CI, 0.22-0.25), and eyes/ears/nose/throat (OR, 0.09; 95% CI, 0.079-0.094) had a lower odds of being transferred as compared with trauma/injury and poisoning. Children younger than 1 year had relatively higher transfer rates. Patients covered by Medicaid and self-pay had the lowest likelihood of transfer. Transfer rates varied significantly by condition and the high-transfer diagnostic categories were related to circulatory, endocrine, nervous, hematology-oncology, and mental disorders as well as congenital anomalies, which may be related to a lack of ED or inpatient resources to care for children with problems that require more complex care.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053974833

Download citation: RISBibTeXText

PMID: 29406473

DOI: 10.1097/pec.0000000000001386


Related references

The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors. International Journal of Emergency Medicine 7: 18, 2014

Tu1999 Intestinal Volvulus in the United States: A Population-Based Assessments of Emergency Departments Visits From the Nationwide Emergency Department Sample. Gastroenterology 144(5): S-900, 2013

Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample. JAMA Oncology 3(10): E172450, 2017

Hospital-based emergency department visits in children with motor vehicle traffic accidents: estimates from the nationwide emergency department sample. World Journal of Pediatrics 11(3): 261-266, 2015

Cost and utilization analysis of a pediatric emergency department diversion project. Pediatrics 116(5): 1075-1079, 2005

Oncologic emergencies in a cancer center emergency department and in general emergency departments countywide and nationwide. Plos one 13(2): E0191658, 2018

The cost of inpatient endometriosis treatment: an analysis based on the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. American Journal of Managed Care 4(8): 1127-1134, 1998

Emergency Department Pediatric Transfers to Acute Care Facilities: An Hcup Analysis. Annals of Emergency Medicine 66(4): S85-S86, 2015

Incidence, admission rates, and economic burden of pediatric emergency department visits for urinary tract infection: data from the nationwide emergency department sample, 2006 to 2011. Journal of Pediatric Urology 11(5): 246.E1-8, 2015

Emergency department visits for acute pancreatitis in children: results from the Nationwide Emergency Department Sample 2006-2011. Journal of Investigative Medicine 63(4): 646-648, 2016

Su1068 Emergency Department Visits for Acute Pancreatitis in Children: Results From the Nationwide Emergency Department Sample 2006 - 2011. Gastroenterology 148(4): S-398-S-399, 2015

Comparing Utilization and Costs of Care in Freestanding Emergency Departments, Hospital Emergency Departments, and Urgent Care Centers. Annals of Emergency Medicine 70(6): 846-857.E3, 2017

Impact of opening a new emergency department on healthcare service and patient outcomes: analyses based on linking ambulance, emergency and hospital databases. Internal Medicine Journal 43(12): 1293-1303, 2013

Transfer of elderly patients from health care facilities to emergency departments: Prospective observational study of the emergency department in Japan. Geriatrics & Gerontology International 3(4): 250-255, 2003

Patient-reported reasons for seeking emergency care at a freestanding emergency department compared to a hospital-based ED. American Journal of Emergency Medicine 36(9): 1702-1704, 2018