title: Reverse transport of children from a tertiary pediatric hospital.
abstract: BACKGROUND
  The purpose of this study was to determine the epidemiology and resources used and to study the potential savings of pediatric reverse transport patients.
  
  
  METHODS
  A case control study was performed with patients undergoing a reverse or outbound transport from a large, pediatric hospital. Twenty-five children undergoing reverse transport were compared with matched controls. Lengths of stay and costs were compared between the reverse transport and matched control patients.
  
  
  RESULTS
  Fifty-two percent of the reverse transport patients returned home, whereas 32% went home for end-of-life care and 16% went to other facilities. The average reverse transport was more than 400 miles and cost $6,064. The reverse transport of these patients did not save pediatric intensive care unit (PICU) days but did result in a shorter hospital stay compared with the matched controls (10 vs. 19 days, P = .03). Decreased utilization of bed days came from less use of intermediate care unit resources.
  
  
  CONCLUSIONS
  Pediatric patients undergo reverse transports for a variety of reasons, often for end-of-life care. The ability to reverse transport pediatric patients may not save PICU bed days but may offer pediatric tertiary care hospitals a means to provide more intermediate care bed availability.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, 6621 Fannin, Houston, TX 77030, USA.
authors.forename: Mona L
authors.initials: ML
authors.lastname: McPherson
authors.forename: Larry S
authors.initials: LS
authors.lastname: Jefferson
authors.forename: E O'Brian
authors.initials: EO
authors.lastname: Smith
authors.forename: Garry C
authors.initials: GC
authors.lastname: Sitler
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Graf
mesh_terms: D017732:Air Ambulances / Q000458:organization & administration*; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D014187:Transportation of Patients / Q000191:economics / Q000379:methods*