Factors associated with discharge of children from the emergency department after interfacility transfer

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. CONCLUSIONS: 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.