PSRC 69th Annual Meeting 2024

Provider Characteristics and Pre-Transfer Costs of Potentially Avoidable Transfers for Pediatric Facial Fracture Patients within UPMC

Background:

•Pediatric facial fractures, while rare, necessitate prompt and specialized medical attention

•Pediatric facial trauma patients are often ”inappropriately” transferred to specialized children’s hospitals despite capacity for referring hospital to manage care

•Potentially Avoidable Transfers (PAT), defined as a patient with a length of stay less than one day, no admission, no surgery, and no emergent procedure performed after transfer, are costly for patients, their families, and hospital systems

Objectives:

•Elucidate the provider and facility characteristics associated with PAT

•Estimate the costs of PAT borne by patients

Methods:

Retrospective cohort study from 2006 – 2021 of patients ≤18 years of age with facialfracturediagnosis. Analysis and data utilized:

•Multivariable logistic regression

•Odds ratio analysis

•UPMC Charge Description Master file

•DHS ambulance fees

Conclusions:

•PAT is associated with initial presentation to advanced practice providers, as well as to non-trauma center hospital Eds

•Three out of four facilities with the highest number of PAT are non-trauma centers

•Our findings highlight provider and facility characteristics that are potential avenues for alleviating the burden from PAT

Limitations/Future Directions:

•Limitation: Costs were estimated based on charges and published ambulance fees, which might not be lower than the actual costs incurred

•Next Steps: Identify opportunities for community outreach and provider education to minimize PAT numbers and improve patient experiences

Contact:

Shirley Liu

University of Pittsburgh School of Medicine

Email: xil383@pitt.edu

PSRC 69th Annual Meeting 2024

Provider Characteristics And Pre-transfer Costs Of Potentially Avoidable Transfers For Pediatric Facial Fracture Patients In A Single Institution

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