Journal article
Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and Costs Across Six Networks
Telemedicine journal and e-health, Vol.27(5), pp.481-487
05/2021
DOI: 10.1089/tmj.2020.0080
PMID: 32835620
Abstract
This analysis identified the rate of transfers and averted transfers and their associated costs across multiple emergency department telemedicine (teleED) networks.
This study is a prospective cohort analysis in six teleED networks operating in 65 hospitals in 11 states across the United States. Each submitted uniform data on all teleED encounters for a 26-month period to a data co-ordinating center. Averted transfers were identified if an encounter met specific criteria. Cost savings from averted transfers were estimated from hospital-specific costs of transferred patients.
A total of 4,324 teleED encounters were reported. Excluding patients who died, 1,934 (46.2%) were transferred to another inpatient facility. Records of the remaining 2,248 teleED patients were examined and 882 (39.2% of nontransfers; 20.4% of all teleED cases) teleED patients met the criteria for an averted transfer. Of the averted transfer cases, 53.3% were admitted to the local inpatient facility, and 43.5% were discharged. Patients who averted transfer had lower levels of severity and less billed services than those who were transferred. Transport savings for averted transfers were estimated to total $1,074,663 annually across the six teleED networks. Average estimated transport savings were $2,673 for each averted transfer.
In a large cohort of teleED cases, 39% of nontransfer cases were averted transfers (20% of all teleED cases). Importantly, 43% of these patients were routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance.
Details
- Title: Subtitle
- Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and Costs Across Six Networks
- Creators
- Marcia M Ward - Department of Health Management and Policy and College of Public Health, University of Iowa, Iowa City, Iowa, USAKnute D Carter - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USAFred Ullrich - Department of Health Management and Policy and College of Public Health, University of Iowa, Iowa City, Iowa, USAKimberly A S Merchant - Department of Health Management and Policy and College of Public Health, University of Iowa, Iowa City, Iowa, USANabil Natafgi - Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USAXi Zhu - Department of Health Management and Policy and College of Public Health, University of Iowa, Iowa City, Iowa, USAPaula Weigel - Department of Health Management and Policy and College of Public Health, University of Iowa, Iowa City, Iowa, USASarah Heppner - Office of Rural Health Policy, Health Resources and Services Administration, Rockville, Maryland, USANicholas M Mohr - Department of Anesthesia, Division of Critical Care, College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.27(5), pp.481-487
- DOI
- 10.1089/tmj.2020.0080
- PMID
- 32835620
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Language
- English
- Date published
- 05/2021
- Academic Unit
- Rural Telehealth Research Center; Health Management and Policy; Epidemiology; Emergency Medicine; Biostatistics; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984221642702771
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