ArticleNeurosurgery2016
Identification and Cost of Potentially Avoidable Transfers to a Tertiary Care Neurosurgery Service: A Pilot Study.
Article in Neurosurgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Transfer versus direct-visit patients in medically underserved emergency departments: a retrospective cohort study.BMC emergency medicine · 2025Article
- Factors associated with radiographic progression and neurologic decline in patients with isolated traumatic subarachnoid hemorrhage.Chinese neurosurgical journal · 2024Article
- Hospital to Hospital Transfers of Cerebral Hemorrhage: Characteristics of Early Withdrawal of Life-Sustaining Treatment.Neurocritical care · 2024Article
- Dissecting patterns and predictors of interhospital transfers for patients with brain metastasis.Journal of neurosurgery · 2024Article
- Interhospital transfer dynamics for patients with intracranial hemorrhage in Massachusetts.Frontiers in neurology · 2024Article
- Process improvement using telemedicine consultation to prevent unnecessary interfacility transfers for low-severity blunt head trauma.BMJ open quality · 2023Article
- Implementation and impact of a point of care electroencephalography platform in a community hospital: a cohort study.Frontiers in digital health · 2023Article
- Observational
- Article
- State of telemedicine use in pediatric surgery in the USA-where we stand and what we can gain from the COVID-19 pandemic: a scoping review.World journal of pediatric surgery · 2021Article
- Inter-facility transfer of patients with traumatic intracranial hemorrhage and GCS 14-15: The pilot study of a screening protocol by neurosurgeon to avoid unnecessary transfers.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2020Article
- Article
- The Global Spine Care Initiative: resources to implement a spine care program.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThousands of neurosurgical emergencies are transferred yearly to tertiary care facilities to assume a higher level of care. Several studies have examined how neurosurgical transfers influence patient outcomes, but characteristics of potentially avoidable transfers have yet to be investigated.
objectiveTo identify whether potentially avoidable transfers represent a significant portion of transfers to a tertiary neurosurgical facility.
methodsIn this cohort study, we evaluated 916 neurosurgical patients transferred to a tertiary care facility over a 2-year period. Transfers were classified as potentially avoidable when no neurosurgical diagnostic test, intervention, or intensive monitoring was deemed necessary (n = 180). The remaining transfers were classified as justifiable (n = 736). The main outcomes and measures were age, sex, diagnosis, insurance status, intervention, distance of transfer, length of hospital and intensive care unit stay, mortality, discharge disposition, and cost.
resultsNearly 20% of transfers were identified as being potentially avoidable. Although some of these patients had suffered devastating, irrecoverable neurological insults, many had innocuous conditions that did not require transfer to a higher level of care. Justifiable transfers tend to involve patients with nontraumatic intracranial hemorrhage and cranial neoplasm. Both groups were admitted to the intensive care unit at the same rate (approximately 70% of patients). Finally, the direct transportation cost of potentially avoidable transfers was $1.46 million over 2 years.
conclusionThis study identified the frequency and expense of potentially avoidable transfers. There is a need for closer examination of the clinical and financial implications of potentially avoidable transfers. ABBREVIATIONS: CI, confidence intervalIQR, interquartile rangeJT, justifiable transferOR, odds ratioPAT, potentially avoidable transferUAB, University of Alabama at Birmingham.
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