PMID- 32835620
OWN - NLM
STAT- MEDLINE
DCOM- 20210521
LR  - 20210521
IS  - 1556-3669 (Electronic)
IS  - 1530-5627 (Linking)
VI  - 27
IP  - 5
DP  - 2021 May
TI  - Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and 
      Costs Across Six Networks.
PG  - 481-487
LID - 10.1089/tmj.2020.0080 [doi]
AB  - Objective: This analysis identified the rate of transfers and averted transfers 
      and their associated costs across multiple emergency department telemedicine 
      (teleED) networks. Methods: 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. Results: 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. Conclusions: 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.
FAU - Ward, Marcia M
AU  - Ward MM
AD  - Department of Health Management and Policy and College of Public Health, 
      University of Iowa, Iowa City, Iowa, USA.
FAU - Carter, Knute D
AU  - Carter KD
AD  - Department of Biostatistics, College of Public Health, University of Iowa, Iowa 
      City, Iowa, USA.
FAU - Ullrich, Fred
AU  - Ullrich F
AD  - Department of Health Management and Policy and College of Public Health, 
      University of Iowa, Iowa City, Iowa, USA.
FAU - Merchant, Kimberly A S
AU  - Merchant KAS
AD  - Department of Health Management and Policy and College of Public Health, 
      University of Iowa, Iowa City, Iowa, USA.
FAU - Natafgi, Nabil
AU  - Natafgi N
AD  - Department of Health Services Policy & Management, Arnold School of Public 
      Health, University of South Carolina, Columbia, South Carolina, USA.
FAU - Zhu, Xi
AU  - Zhu X
AD  - Department of Health Management and Policy and College of Public Health, 
      University of Iowa, Iowa City, Iowa, USA.
FAU - Weigel, Paula
AU  - Weigel P
AD  - Department of Health Management and Policy and College of Public Health, 
      University of Iowa, Iowa City, Iowa, USA.
FAU - Heppner, Sarah
AU  - Heppner S
AD  - Office of Rural Health Policy, Health Resources and Services Administration, 
      Rockville, Maryland, USA.
FAU - Mohr, Nicholas M
AU  - Mohr NM
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa 
      City, Iowa, USA.
AD  - Department of Emergency Medicine and Division of Critical Care, College of 
      Medicine, University of Iowa, Iowa City, Iowa, USA.
AD  - Department of Anesthesia, Division of Critical Care, College of Medicine, 
      University of Iowa, Iowa City, Iowa, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20200824
PL  - United States
TA  - Telemed J E Health
JT  - Telemedicine journal and e-health : the official journal of the American 
      Telemedicine Association
JID - 100959949
SB  - IM
MH  - Emergency Service, Hospital
MH  - Hospitalization
MH  - Humans
MH  - *Patient Transfer
MH  - Prospective Studies
MH  - *Telemedicine
MH  - United States
OTO - NOTNLM
OT  - emergency medicine
OT  - policy
OT  - telehealth
OT  - telemedicine
OT  - teletrauma
EDAT- 2020/08/25 06:00
MHDA- 2021/05/22 06:00
CRDT- 2020/08/25 06:00
PHST- 2020/08/25 06:00 [pubmed]
PHST- 2021/05/22 06:00 [medline]
PHST- 2020/08/25 06:00 [entrez]
AID - 10.1089/tmj.2020.0080 [doi]
PST - ppublish
SO  - Telemed J E Health. 2021 May;27(5):481-487. doi: 10.1089/tmj.2020.0080. Epub 2020 
      Aug 24.