Peer-reviewed article
2082 Profile of pediatric potentially avoidable transfers
Rosenthal J, Marcin J, Lieng M, Romano P ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study describes patterns of pediatric hospital transfers that result in early discharge without specialized treatment at a single US hospital. The researchers found that about 14% of transferred pediatric patients were discharged within 24 hours without receiving tests, interventions, consultations, or new diagnoses. Direct admissions to the hospital (rather than through the emergency department) were more likely to be potentially avoidable transfers, particularly to non-intensive care units. The most common diagnoses among these cases were respiratory infections, asthma, and fractures.
Key points
- 31.2% of 2414 pediatric transfers were discharged within 24 hours
- 14.4% of total transfers (348 patients) received no specialized tests, interventions, consultations, or diagnoses
- Direct admissions were 2.2 times more likely to be categorized as potentially avoidable transfers than transfers through the emergency department
- Among direct admissions, potentially avoidable transfer rates were 5.8% to neonatal ICU, 17.4% to pediatric ICU, and 27.3% to non-ICU settings
- Respiratory infections, asthma, and fractures were the most common diagnoses in potentially avoidable transfers
Limitations
This is a single-center descriptive study with no comparison group, so findings may not generalize to other settings. The study identifies patterns but cannot establish causation or determine the clinical appropriateness of these transfers, nor does it assess patient outcomes or safety implications.
Abstract
OBJECTIVES/SPECIFIC AIMS: While hospital-hospital transfers of pediatric patients is often necessary, some pediatric transfers are potentially avoidable. Pediatric potentially avoidable transfers (PAT) represent a process with high costs and safety risks but few, if any, benefits. To better understand this issue, we described pediatric inter-facility transfers with early discharges. METHODS/STUDY POPULATION: We conducted a descriptive study using electronic medical record data at a single-center over a 12-month period to examine characteristics of pediatric patients with a transfer admission source and early discharge. Among patients with early discharges, we performed descriptive statistics for PAT defined as patient transfers with a discharge home within 24 hours without receiving any specialized tests, interventions, consultations, or diagnoses. RESULTS/ANTICIPATED RESULTS: Of the 2414 pediatric transfers 31.2% were discharged home within 24 hours. Among transferred patients with early discharges, 348 patients (14.4% of total patient transfers) received no specialized tests, interventions, consultations, or diagnoses. Direct admissions were categorized as PAT 2.2-fold more frequently than transfers arriving to the emergency department. Among transferred direct admissions, PAT proportions to the neonatal intensive care unit (ICU), pediatric ICU, and non-ICU were 5.8%, 17.4%, and 27.3%, respectively. Respiratory infections, asthma, and fractures were the most common PAT diagnoses. DISCUSSION/SIGNIFICANCE OF IMPACT: Early discharges and PAT are relatively common among transferred pediatric patients. Further studies are needed to identify the etiologies and clinical impacts of PAT, with a focus on direct admissions given the high frequency of PAT among direct admissions to both the pediatric ICU and non-ICU.