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Investigation of the status of interhospital transport of critically ill pediatric patients
Jun Qiu, Xiao-Li Wu, Zheng-Hui Xiao, Xian Hu, Xue-Li Quan, Yi-Min Zhu
Changsha, China
Author Affiliations: Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha 410007, China (Qiu J, Xiao ZH, Hu X, Quan XL, Zhu YM); Department of Obstetrics and Gynecology, Maternal And Child Health Hospital Of Hunan Province, Changsha 410007, China (Wu XL)
Corresponding Author: Yi-Min Zhu, PhD, Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha 410007, China (Tel: +8613907315063; Fax: +8673085600902; Email: cszhuyimin@126.com)
doi: 10.1007/s12519-015-0004-8
Background: With the unequal distribution of medical resources in developing countries, critically ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources. Although a large number of critically ill children are transferred each day in China, the standard process of inter-hospital transport is not formulated.
Methods: We retrospectively analyzed the data collected during transport. A total number of 9231 patients (¡Ü14 years) who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1, 2009 to June 30, 2012 were included in the study.
Results: Nearly half of the critically ill children were neonates (48.72%) and two thirds of the children were suffering from respiratory, neurological and cardiac diseases. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression. Mobilization time in non-working hours was longer than the working hours (OR=1.186, 95% CI=1.059-1.329). Our study showed that mobilization time for neonates was shorter than that for older children (OR=0.801, 95% CI=0.692-0.928). The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km (OR=0.427, 95% CI=0.350-0.521). Referred patients in summer needed a significantly shorter mobilization time than in winter (OR=0.705, 95% CI=0.616-0.806).
Conclusion: Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.
World J Pediatr 2015;11(1):67-73
Key words: critically ill pediatric patients;
inter-hospital transport;
specialist retrieval teams
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