Andrew Downie, Titus Mashanya, Beatrice Chipwaza, Frances Griffiths, Bronwyn Harris, Albino Kalolo, Sylvester Ndegese, Jackie Sturt, Nicole De Valliere, Senga Pemba
Remote Consulting in Primary Health Care in Low- and Middle-Income Countries: Feasibility Study of an Online Training Program to Support Care Delivery During the COVID-19 Pandemic
JMIR formative research
describe interfacility transfers among children complex chronic conditions cccs determine interfacility transfer associated health outcomes hypothesized interfacility transfer would associated length stay los receipt critical care services inhospital mortality retrospective cohort study used data 2012 kids inpatient database ccc hospitalizations identified international classification diseases ninth revision codes receipt critical care services inferred using international classification diseases ninth revision diagnosis procedure codes performed descriptive analysis ccc hospitalizations determined transfer associated los mortality receipt critical care services using surveyadapted quasipoisson logistic regression models controlling hospital patient demographics 551 974 nonbirth hospitalizations least 1 ccc diagnosis code 13 involved interfacility transfer compared patients cccs transferred patients cccs transferred ultimately discharged receiving hospital adjusted los rate ratio 16 95 confidence interval ci 1517 p 001 likely received critical care services adjusted odds ratio 30 95 ci 2732 p 001 higher inhospital mortality adjusted odds ratio 36 95 ci 3239 p 001 controlling patient hospital characteristics many hospitalizations children cccs involve interfacility transfer compared inhouse admissions hospitalizations patients transferred ultimately discharged receiving hospital involve longer los greater odds receipt critical care services inhospital mortality evaluation role clinical transfer logistic factors needed improve outcomes