Document Detail


Easing the strain on a pediatric tertiary care center: use of a redistribution system.
MedLine Citation:
PMID:  17768287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the ability of a regionalized system to safely transfer patients requiring admission from a referral center to either regional or community hospitals. DESIGN: Cohort study of children requiring admission. Following transfer, a questionnaire was administered to eligible caregivers. Subsequent emergency department (ED) use was assessed by comparing children who were transferred with those who were not. SETTING: The Hospital for Sick Children, Toronto, Ontario, Canada, from April 1, 2003, through March 31, 2004. PARTICIPANTS: Caregivers of 371 children who underwent transfer from a tertiary care center ED to either a regional or a community hospital were eligible; 344 were contacted. Two hundred fifty-three children for whom transfer was considered but was not performed served as a comparison group. Intervention Questionnaire administered to caregivers, combined with database review. MAIN OUTCOME MEASURES: Failure of the transfer process, caregiver satisfaction, and future tertiary care center ED use. RESULTS: Five children experienced intravenous access problems, and 4 children experienced delayed antibiotic administration. Caregiver satisfaction was 92.3% with the transfer process and 84.4% with the care at the receiving hospital. Forty-seven percent of caregivers indicated that they would agree to a similar transfer in the future. Two years later, fewer transferred children (39.9%) than those who were not transferred (49.6%) had revisited the tertiary care center ED (odds ratio, 1.52; 95% confidence interval, 1.10-2.10). The mean number of visits was unchanged (95% confidence interval of the difference, -0.44 to 0.21 visits). CONCLUSIONS: Although we found the redistribution program to be safe, caregivers stated a preference not to be transferred again. The redistribution system did not substantially alter tertiary care center ED use.
Authors:
Stephen B Freedman; Vidhi A Thakkar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  161     ISSN:  1072-4710     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-04     Completed Date:  2007-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  870-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Paediatric Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada. stephen.freedman@sickkids.ca
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MeSH Terms
Descriptor/Qualifier:
Caregivers
Child
Emergency Service, Hospital / organization & administration*
Hospitals, Community / organization & administration*
Hospitals, Pediatric / organization & administration*
Humans
Length of Stay
Ontario
Patient Transfer / organization & administration*
Questionnaires
Regional Medical Programs*
Retrospective Studies
Comments/Corrections
Comment In:
Arch Pediatr Adolesc Med. 2007 Sep;161(9):911-3   [PMID:  17768294 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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