{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:25:53Z","timestamp":1792113953396,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,8,4]],"date-time":"2016-08-04T00:00:00Z","timestamp":1470268800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008893","name":"University of Iowa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008893","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008893","name":"University of Iowa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008893","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008893","name":"University of Iowa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008893","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Interhospital transfer is a common strategy to provide high\u2010quality regionalized care in rural emergency departments (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>s), but several reports have highlighted problems with selection of children for transfer. The purpose of this study is to characterize the burden of potentially avoidable transfer (<jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content>) and to estimate the medical and family\u2010oriented costs associated with <jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a cohort study of all children treated in Iowa <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>s between 2004 and 2013. <jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content> was defined as a child who was transferred and then either discharged from the receiving <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> or admitted for \u2264 1\u00a0day, without having any separately billed procedures performed. Costs of care were estimated from 1) medical costs, 2) ambulance transfer, and 3) family costs (travel and lodging).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 10\u00a0years, 2,117,317 children were included (1% transferred to another hospital). Only 63% were transferred to a designated children's hospital, and <jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content>s were identified in 39% of all transfers. <jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content> was associated with $909 in additional cost. The conditions most strongly associated with <jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content> were seizure (additional cost $1,138), fracture ($814), isolated traumatic brain injury without extra\u2010axial bleeding ($1,455), respiratory infection ($556), and wheezing ($804). Few of these charges are attributable to nonmedical family costs ($21).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Potentially avoidable pediatric interhospital transfer is common and is responsible for significant healthcare\u2010related costs. Future work should focus on improving selection of children who benefit from interhospital transfer for high\u2010yield conditions, to reduce the costly and distressing burden that <jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content> places on rural patients and their families.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12972","type":"journal-article","created":{"date-parts":[[2016,3,28]],"date-time":"2016-03-28T08:32:38Z","timestamp":1459153958000},"page":"885-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":98,"title":["Potentially Avoidable Pediatric Interfacility Transfer Is a Costly Burden for Rural Families: A Cohort Study"],"prefix":"10.1111","volume":"23","author":[{"given":"Nicholas M.","family":"Mohr","sequence":"first","affiliation":[{"name":"University of Iowa Carver College of Medicine Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karisa K.","family":"Harland","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan M.","family":"Shane","sequence":"additional","affiliation":[{"name":"University of Iowa College of Public Health Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[{"name":"University of Iowa College of Public Health Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.3.647"},{"key":"e_1_2_8_3_1","volume-title":"Pediatric Care in Rural Hospital Emergency Departments","year":"2010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2012.8.12783"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1865-1380-6-13"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1517"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000061"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1819"},{"key":"e_1_2_8_9_1","unstructured":"Clinical Classifications Software (CCS) for ICD\u20109\u2010CM. Agency for Healthcare Research and Quality 2015. Available at:http:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/ccs\/ccs.jsp. Accessed Jun 2015"},{"key":"e_1_2_8_10_1","unstructured":"Surgery Flag Software.2015. Available at:http:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/surgflags\/surgeryflags.jsp. Accessed Jun 2015."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.6.e99"},{"key":"e_1_2_8_12_1","unstructured":"Google Maps APIs.2014. Available at:https:\/\/developers.google.com\/maps\/?hl=en. Accessed Feb 2015."},{"key":"e_1_2_8_13_1","unstructured":"Texas A&M University Geoservices.2014. Available at:http:\/\/geoservices.tamu.edu. Accessed Dec 2014."},{"key":"e_1_2_8_14_1","unstructured":"U.S. Gazetteer Files.U.S. Census 2010. Available at:http:\/\/www.census.gov\/geo\/maps-data\/data\/gazetteer.html. Accessed Feb 2015."},{"key":"e_1_2_8_15_1","unstructured":"Consumer Price Index \u2010 Medical Care.Bureau of Labor Statistics. Available at:http:\/\/data.bls.gov\/timeseries\/CUUR0000SAM. Accessed Mar 2015."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318232db65"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3795"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12103"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000911"},{"key":"e_1_2_8_20_1","unstructured":"IRS Announces 2010 Standard Mileage Rates.Internal Revenue Service 2009. Available at:https:\/\/www.irs.gov\/uac\/IRS-Announces-2010-Standard-Mileage-Rates. Accessed Mar 2015."},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2900"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2015.0043"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X15584916"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000337"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2014.04.015"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facem.12972","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.12972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T19:20:07Z","timestamp":1695756007000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.12972"}},"subtitle":[],"editor":[{"given":"Craig D.","family":"Newgard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1111\/acem.12972"],"URL":"https:\/\/doi.org\/10.1111\/acem.12972","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8]]},"assertion":[{"value":"2016-01-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-03-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}