传输(计算)
医学
急诊医学
医疗急救
急诊科
队列
人口学
精神科
计算机科学
内科学
社会学
并行计算
作者
Marcia M. Ward,Knute D. Carter,Fred Ullrich,Kimberly A S Merchant,Nabil Natafgi,Xi Zhu,Paula Weigel,Sarah Heppner,Nicholas M. Mohr
出处
期刊:Telemedicine Journal and E-health
[Mary Ann Liebert]
日期:2021-05-01
卷期号:27 (5): 481-487
被引量:9
标识
DOI:10.1089/tmj.2020.0080
摘要
Objective: This analysis identified the rate of transfers and averted transfers and their associated costs across multiple emergency department telemedicine (teleED) networks. Methods: This study is a prospective cohort analysis in six teleED networks operating in 65 hospitals in 11 states across the United States. Each submitted uniform data on all teleED encounters for a 26-month period to a data co-ordinating center. Averted transfers were identified if an encounter met specific criteria. Cost savings from averted transfers were estimated from hospital-specific costs of transferred patients. Results: A total of 4,324 teleED encounters were reported. Excluding patients who died, 1,934 (46.2%) were transferred to another inpatient facility. Records of the remaining 2,248 teleED patients were examined and 882 (39.2% of nontransfers; 20.4% of all teleED cases) teleED patients met the criteria for an averted transfer. Of the averted transfer cases, 53.3% were admitted to the local inpatient facility, and 43.5% were discharged. Patients who averted transfer had lower levels of severity and less billed services than those who were transferred. Transport savings for averted transfers were estimated to total $1,074,663 annually across the six teleED networks. Average estimated transport savings were $2,673 for each averted transfer. Conclusions: In a large cohort of teleED cases, 39% of nontransfer cases were averted transfers (20% of all teleED cases). Importantly, 43% of these patients were routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance.
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