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Effects of an emergency transfer coordination center on secondary overtriage in an emergency department

Authors
 Eung Nam Kim  ;  Min Joung Kim  ;  Je Sung You  ;  Hye Jung Shin  ;  In Cheol Park  ;  Sung Phil Chung  ;  Ji Hoon Kim 
Citation
 AMERICAN JOURNAL OF EMERGENCY MEDICINE, Vol.37(3) : 395-400, 2019 
Journal Title
 AMERICAN JOURNAL OF EMERGENCY MEDICINE 
ISSN
 0735-6757 
Issue Date
2019
MeSH
Aged ; Aged, 80 and over ; Emergency Service, Hospital/organization & administration* ; Female ; Hospitalization ; Humans ; Injury Severity Score ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Outcome and Process Assessment (Health Care) ; Patient Transfer/organization & administration* ; Referral and Consultation/organization & administration* ; Registries ; Republic of Korea ; Retrospective Studies ; Rural Health Services/organization & administration* ; Triage/organization & administration*
Keywords
Emergency transfer ; Secondary overtriage ; Transfer coordination
Abstract
BACKGROUND: Patients who cannot be stabilized at a lower-level emergency department (ED) should be transferred to an upper-level ED by emergency medical services. However, some patients are subsequently discharged after transfer without any intervention or admission, and this secondary overtriage (SO) wastes the limited resources of upper-level EDs. This study aimed to investigate whether an emergency transfer coordination center (ETCC) could reduce the risk of SO among patients who were transferred to a tertiary ED by emergency medical services. METHODS: This retrospective observational study evaluated data from a prospective registry at an urban tertiary ED in Korea (January 2017 to May 2017). The exposure of interest was defined as ETCC approval prior to transfer and the primary outcome was SO. Univariate analyses were used to identify statistically significant variables, which were used for a multivariate logistic regression analysis to estimate the effects of ETCC approval on SO. RESULTS: During the study period, 1270 patients were considered eligible for this study. A total of 291 transfers were approved by the center's ETCC, and the remaining patients were transferred without approval. Compared to cases without ETCC approval, cases with transfer after ETCC approval had a significantly lower risk of SO (odds ratio: 0.624, 95% confidence interval: 0.413-0.944). CONCLUSION: Transfers that were evaluated by an ETCC had a lower risk of SO, which may improve the appropriateness of transfer. Thus, tertiary EDs that have high proportions of transferred patients should have a transfer coordination system that is similar to an ETCC.
Full Text
https://www.sciencedirect.com/science/article/pii/S0735675718304406
DOI
29861365
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173135
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