title: Investigation of the status of interhospital transport of critically ill pediatric patients.
abstract: BACKGROUND
  With the unequal distribution of medical resources in developing countries, critically ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources. Although a large number of critically ill children are transferred each day in China, the standard process of inter-hospital transport is not formulated.
  
  
  METHODS
  We retrospectively analyzed the data collected during transport. A total number of 9231 patients (≤14 years) who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1, 2009 to June 30, 2012 were included in the study.
  
  
  RESULTS
  Nearly half of the critically ill children were neonates (48.72%) and two thirds of the children were suffering from respiratory, neurological and cardiac diseases. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression. Mobilization time in non-working hours was longer than the working hours (OR=1.186, 95% CI=1.059-1.329). Our study showed that mobilization time for neonates was shorter than that for older children (OR=0.801, 95% CI=0.692-0.928). The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km (OR=0.427, 95% CI=0.350-0.521). Referred patients in summer needed a significantly shorter mobilization time than in winter (OR=0.705, 95% CI=0.616-0.806).
  
  
  CONCLUSIONS
  Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.
authors.affiliation: Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qiu
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Wu
authors.forename: Zheng-Hui
authors.initials: ZH
authors.lastname: Xiao
authors.forename: Xian
authors.initials: X
authors.lastname: Hu
authors.forename: Xue-Li
authors.initials: XL
authors.lastname: Quan
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Zhu
mesh_terms: D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010360:Patient Transfer / Q000592:standards / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data
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