Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, 410007, China.
World J Pediatr. 2015 Feb;11(1):67-73. doi: 10.1007/s12519-015-0004-8. Epub 2015 Jan 28.
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.
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.
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).
Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.
在发展中国家，医疗资源分布不均，重症患儿需要从资源有限的基层医院转往三级医院。尽管中国每天都有大量重症患儿转院，但尚未制定出标准的院际转运流程。
我们对转运过程中收集的数据进行了回顾性分析。纳入了自 2009 年 1 月 1 日至 2012 年 6 月 30 日期间，由基层医院的专门团队转往湖南省儿童医院的 9231 名（≤14 岁）患儿。
将近一半的重症患儿为新生儿（48.72%），三分之二的患儿患有呼吸、神经和心脏疾病。使用非条件 logistic 回归计算多变量校正比值比（OR）和 95%置信区间（CI）。非工作时间的转运时间长于工作时间（OR=1.186，95% CI=1.059-1.329）。我们的研究表明，新生儿的转运时间短于较大儿童（OR=0.801，95% CI=0.692-0.928）。50 公里半径范围内的转诊病例的转运时间短于 250 公里半径范围内的转诊病例（OR=0.427，95% CI=0.350-0.521）。夏季转诊患者的转运时间明显短于冬季（OR=0.705，95% CI=0.616-0.806）。
标准化的院际转运流程和指南对于确保患者的有效转运和减少转运启动时间至关重要。
