Interfacility Transfer Rates for Children with Croup, Asthma, and Gastroenteritis

Regionalization of care for children (i.e., sending more children to pediatric centers) is beneficial for those with some complex medical conditions, but may lead to overcrowding and waste if it is applied to more-common, less-serious conditions. These authors measured referral rates — defined as the number of children transferred divided by the number of children not discharged from the emergency department (ED) — for those with croup, asthma, and gastroenteritis.

Using the National Emergency Department Sample database, the authors identified roughly 13.5 million ED visits for these conditions from 2008 to 2016 by patients ≤18 years old. About 0.6% of visits were excluded because the patient received a critical care diagnosis or interventio…