title: Why burn patients are referred?
abstract: BACKGROUND
  Many burn patients are needed to be referred to a tertiary burn hospital according to the American Burn Association (ABA) criteria. The purpose of this study was to verify the reasons for referring of the burn patients to the hospital.
  
  
  METHODS
  For 2 years, we prospectively surveyed the burn patients referred to a tertiary teaching burn hospital. Data for the following variables were collected and analyzed with SPSS software V21.0: causes of burn; age; gender; total body surface area (TBSA) measured at the referring center; TBSA measured at the receiving center; concomitant diseases and traumas; the reason for referral; condition of patients before and during the transportation; transportation time; presence of infection; presence of inhalation injury, electrical injury, and chemical injury; child abuse; insurance coverage; and results and outcomes of patients.
  
  
  RESULTS
  A total of 578 burn patients (33.6% of the total admissions) were referred in the study period. Among these patients, 70.9% were females. The mean (SD) age of the patients was 35.3 (19.69) years. The mean (SD) of TBSA was 45.2 (26.3). Of the 578 patients, 45% were referred by request of the family or patients; 9% were referred because lack of diagnostic facility, approximately 43% were referred because of the need to be admitted in a tertiary burn center, 0.7% were referred because of a lack of capacity at other hospitals, and 0.5% were referred because of an error in the estimation of TBSA.
  
  
  CONCLUSIONS
  A total of 45% of the referrals were by request of the family and patients. Tele-medicine may help to establish a direct contact between expert burn physicians and the patients and thus reduce unnecessary transfers. Approximately 9% of the referrals were because of lack of some diagnostic facilities.
authors.affiliation: Faculty of Medicine, Motahary Burn Hospital, School of Medicine, Burn Research Center, Iran University of Medical Sciences, Yasemi Alley, Vali Asr Ave., Tehran 19637, Iran.
authors.forename: Noor-Ahmad
authors.initials: NA
authors.lastname: Latifi
authors.affiliation: Faculty of Medicine, Motahary Burn Hospital, School of Medicine, Burn Research Center, Iran University of Medical Sciences, Yasemi Alley, Vali Asr Ave., Tehran 19637, Iran. Electronic address: hamidkarimi1381@yahoo.com.
authors.forename: Hamid
authors.initials: H
authors.lastname: Karimi
mesh_terms: D000293:Adolescent; D000328:Adult; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns; D002648:Child; D003362:Cost-Benefit Analysis; D005190:Family; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010360:Patient Transfer; D011446:Prospective Studies; D012017:Referral and Consultation; D012042:Registries; D015208:Smoke Inhalation Injury; D017216:Telemedicine; D062606:Tertiary Care Centers; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Burns; Referral; TBSA; Telemedicine; Tertiary burn center