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. 2021 Jun 28;36(25):e172.
doi: 10.3346/jkms.2021.36.e172.

The Prevalence and Emergency Department Utilization of Patients Who Underwent Single and Double Inter-hospital Transfers in the Emergency Department: a Nationwide Population-based Study in Korea, 2016-2018

Youn Jung Kim #  1 , Jung Seok Hong #  2 , Seok In Hong  1 , June Sung Kim  1 , Dong Woo Seo  1 , Ryeok Ahn  2 , Jinwoo Jeong  3 , Sung Woo Lee  4 , Sungwoo Moon  5   6 , Won Young Kim  7
Affiliations

The Prevalence and Emergency Department Utilization of Patients Who Underwent Single and Double Inter-hospital Transfers in the Emergency Department: a Nationwide Population-based Study in Korea, 2016-2018

Youn Jung Kim et al. J Korean Med Sci. .

Abstract

Background: Inter-hospital transfer (IHT) for emergency department (ED) admission is a burden to high-level EDs. This study aimed to evaluate the prevalence and ED utilization patterns of patients who underwent single and double IHTs at high-level EDs in South Korea.

Methods: This nationwide cross-sectional study analyzed data from the National Emergency Department Information System for the period of 2016-2018. All the patients who underwent IHT at Level I and II emergency centers during this time period were included. The patients were categorized into the single-transfer and double-transfer groups. The clinical characteristics and ED utilization patterns were compared between the two groups.

Results: We found that 2.1% of the patients in the ED (n = 265,046) underwent IHTs; 18.1% of the pediatric patients (n = 3,556), and 24.2% of the adult patients (n = 59,498) underwent double transfers. Both pediatric (median, 141.0 vs. 208.0 minutes, P < 0.001) and adult (median, 189.0 vs. 308.0 minutes, P < 0.001) patients in the double-transfer group had longer duration of stay in the EDs. Patient's request was the reason for transfer in 41.9% of all IHTs (111,076 of 265,046). Unavailability of medical resources was the reason for transfer in 30.0% of the double transfers (18,920 of 64,054).

Conclusion: The incidence of double-transfer of patients is increasing. The main reasons for double transfers were patient's request and unavailability of medical resources at the first-transfer hospitals. Emergency physicians and policymakers should focus on lowering the number of preventable double transfers.

Keywords: Delivery of Health Care; Emergency Department; Health Care System; Patient Transfer.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Patient selection flow diagram.
ED = emergency department.
Fig. 2
Fig. 2. The temporal changes in the reasons for transfer among the patients in single-transfer and double-transfer groups in South Korea between 2016 and 2018: (A) pediatric patients and (B) adult patients.
GW = general ward, ICU = intensive care unit.
See this image and copyright information in PMC

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