| Easing the strain on a pediatric tertiary care center: use of a redistribution system. | |
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MedLine Citation:
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PMID: 17768287 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Stephen B Freedman; Vidhi A Thakkar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of pediatrics & adolescent medicine Volume: 161 ISSN: 1072-4710 ISO Abbreviation: Arch Pediatr Adolesc Med Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-04 Completed Date: 2007-10-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9422751 Medline TA: Arch Pediatr Adolesc Med Country: United States |
Other Details:
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Languages: eng Pagination: 870-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Paediatric Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada. stephen.freedman@sickkids.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Arch Pediatr Adolesc Med. 2007 Sep;161(9):911-3
[PMID:
17768294
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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