소아환자의 전원 후 응급실 퇴원 요인
Factors associated with discharge of children from the emergency department after interfacility transfer
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Abstract
Purpose To investigate the factors associated with discharge of children from the emergency department (ED) after interfacility transfer. Methods We reviewed consecutive children who visited the ED via interfacility transfer from January 2014 to December 2015. The children were divided into two groups according to whether they were discharged from the ED or not (the discharge and admission groups), and their characteristics were compared. Multivariable logistic regression analysis was performed to identify the factors associated with discharge of children from the ED after interfacility transfer. Results Of the 999 transferred children, 426 (42.6%) were discharged. Compared to the admission group, these children showed older age, more frequent transfers from clinics and arrivals between 16 h and 20 h, shorter stay in the ED, and less frequent surgical abdomen. We found that age (3 to 6 years; adjusted odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3-2.6, compared with 0 to 2 years), diagnosis (trauma; OR, 2.4; 95% CI, 1.5-4.0, compared with gastrointestinal diseases), and referring hospital (primary clinic; OR, 5.4; 95% CI, 3.1-9.4, compared with tertiary hospitals) were the factors. Conclusion The children who aged 3 to 6 years, had trauma or underwent transfers from primary clinics were more likely to be discharged at the ED. Considering these factors, we should reduce unnecessary transfers.
참고문헌 (15)
- Bourgeois FT, "Emergency care for children in pediatric and general emergency departments", Pediatr Emerg Care, 23, pp.94~102 (2007)
- United States, "Pediatric emergency department visits in community hospitals from selected states", pp.1~12 (2008), Agency for Health Care Policy and Research
- Noh H, "Comparisons of Pediatric patients who visited to the pediatric emergency department and the general emergency department", Pediatr Emerg Med J, 2, pp.29~34 (2015)
- Gattu RK, "Consideration of cost of care in pediatric emergency transfer: an opportunity for improvement", Pediatr Emerg Care, 33, pp.334~338 (2017)
- Alessandrini EA, "A new diagnosis grouping system for child emergency department visits", Acad Emerg Med, 17, pp.204~213 (2010)
- Balachandran B, "Emergency management of acute abdomen in children", Indian J Pediatr, 80, pp.226~234 (2013)
- Li J, "Interfacility transfers of noncritically ill children to academic pediatric emergency departments", Pediatrics, 130, pp.83~92 (2012)
- Walls TA, "Factors associated with emergency department discharge after pediatric interhospital transport: a role for outreach education?", Pediatr Emerg Care, 31, pp.10~14 (2015)
- National Emergency Department Information System annual report 2015, "National Emergency Medical Center", National Emergency Medical Center, 40~ (2015)
- 곽영호, "Utilization of Emergency Department by Children in Korea", Journal of Korean Medical Science, 27(10), pp.1222~1228 (2012), 대한의학회
- Joyce Li, "Reasons for Interfacility Emergency Department Transfer and Care at the Receiving Facility", Pediatric Emergency Care, Publish Ahead of Print (2017), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Mohr NM, "Potentially avoidable pediatric interfacility transfer is a costly burden for rural families: a cohort study", Acad Emerg Med, 23, pp.885~894 (2016)
- Sterner SE, "A new after-hours clinic model provides cost-saving, faster care compared with a pediatric emergency department", Pediatr Emerg Care, 28, pp.1162~1165 (2012)
- Kim MJ, "Non-emergency department models for pediatric after-hours care", Pediatr Emerg Med J, 3, pp.1~8 (2016)
- Leibowitz R, "A systematic review of the effect of different models of after-hours primary medical care services on clinical outcome, medical workload, and patient and GP satisfaction", Fam Pract, 20, pp.311~317 (2003)