Adolescents' interhospital transfers from a pediatric emergency department
Keywords:adolescents, medical specialties, lack of resources, interhospital transfers
Introduction: The maternal-infant referral network, established in Portugal since 2001, allows a complementarity between all healthcare units, providing universal access to healthcare.
Aim: To characterize adolescents interhospital transfers from the Pediatric Urgency (PU) of a B1 hospital..
Methods: Retrospective analytic study. Data from clinical files of adolescents transferred from the PU in 2011 were collected. We defined and compared two age groups: 10 to 14 years old (G1) and 15 to 18 years old (G2) and characterized these about demographics, diagnosis, diagnostic procedures and reason for transfer. Statistical analysis was performed with PASW 18.0® software (p<0,05).
Results: There were 43.409 admissions to the PU, 24,2%(n=10.498) from adolescents, with an average age of 14,5 (±2,1) years; 67% were males. Around 1,2% (n=131) of the adolescents were transferred, which counted for 46% of all transfers in pediatric age. When analyzing admissions by age group, 65,8% belonged to G1 from all transfers and 57,3% to G2 (p<0,001). The reason for transfer was trauma in 45%, medical in 37,4%, and surgical in 17,6%. The main diagnosis of the adolescents transferred were ear-nose-throat problems, urologic and psychiatric conditions. Diagnostic procedures were performed in 42,7% of the adolescents and 82,1% were imaging exams. The lack of specialities, in the emergency department, in the local hospital was the reason for the transfer in 90,8%, and the missing speciality was surgical in 72,2%. Psychiatric conditions were more frequently diagnosed in adolescents transferred from G2 (22,7%) than G1 (9,1%), p=0,037. Of all the adolescents transferred to A1 hospital, 28,2% were admitted for hospitalization.
Conclusions: Although adolescents comprised only a quarter of the admissions of the PU, they represented an important percentage of all transfers, mainly the older ones. The main reason for transfers was the lack of medical and surgical specialities in the PU, namely otorhinolaryngology and psychiatry.
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