A combination of malpractice suit fears and a lack of pediatric orthopedic surgeons may be to blame for costly unnecessary hospital transfers, a new study published in the Journal of Trauma concluded.
Unnecessary transfers, also known as secondary overtriage patients, are defined as those who are discharged from a hospital within 24 hours of being transferred to the facility without undergoing surgery. While overall, secondary overtriage rates were relatively low--less than 7 percent (3,291) of the roughly 51,000 transfer cases studied from 2000 to 2004 were considered unnecessary. The cost of caring for such patients proved to be anything but.
"The mean charge for a case of secondary overtriage was $5,917," wrote the study's authors. That "is a significant burden considering the average healthcare related expenditure per person per year in the United States is $8,047."
What's more, of the nearly 3,300 patients determined to have been transferred unnecessarily, close to 20 percent were pediatric patients (those under the age of 18), a trend the authors chalk up to lack of "appropriate resources" to care for such patients, and possible litigation fears.
"[T]he majority of pediatric patients who were rapidly discharged after transfer had only received minor procedures, such as noninvasive orthopedic procedures," the authors wrote. "[T]he higher rate...also suggests that concerns for malpractice lawsuits may play a role."
Data for the study was pulled from the Nationwide Inpatient Sample, which includes all discharges from a 20 percent sample of hospitals in 37 states, according to the report.
"If you were discharged that quickly, you probably didn't need a transfer," Dr. David Chang of the University of California San Diego, one of the co-authors, told MedPage Today. "You could probably be discharged from the first hospital and followed up with a clinic visit."
To learn more:
- read this press release
- check out this MedPage Today piece
- here's a KPBS brief