Objective To explore the reasons for inter-hospital transport and identify influential factors and objective or subjective reasons behind pediatric patients or their guardians.Methods Six hundred and two inter-hospital transportations of pediatric patients were recruited in the study from 1st August 2012 to 31st May 2013.The information on demographic characteristics,the reasons for inter-hospital transfer,the category of disease and the severity of illness were collected.Frequency description,chi-square test and non-conditional Logistics regression analysis were applied to analyze the data by using SAS 9.2.Results There were 47.17％ (284/602 cases) pediatric patients transferred due to subjective reasons.The proportion of inter-hospital transfers was significantly different as a result of objective or subjective reasons in the different age categories (x2 =81.10,P ＜0.001).The percentage of inter-hospital transfers in pediatriceonatal intensive care unit (43.67％) was lower than pediatric ward (57.21％)as a result of subjective reasons from referring hospitals (x2 =23.47,P ＜ 0.001).The proportion of inter-hospitals transfers from non-tertiary hospitals (40.08％) was lower than that from tertiary hospitals (52.65％) as a result of subjective reasons,and the difference was statistically significant (x2 =9.38,P =0.002) ; 39.44％ critically ill pediatric patients were transferred,whereas 65.91％ non-critically ill pediatric patients were transferred due to subjective reasons,and there was statistical significance (x2 =35.02,P ＜ 0.001).The level of referring hospital,the referring department and the severity of illness were influence factors for inter-hospital transfers as a result of subjective reasons through multivariate Logistic regression analysis (P ＜ 0.05).Conclusions Nearly half (47.17％) of pediatric patients were transferred because of objective reasons from referring hospitals.The level of referring hospital,the referring department and the severity of illness were influence factors for inter-hospital transfers as a result of subjective reasons.%目的 了解院间转诊患儿选择转诊的原因,分析影响重症患儿或其监护人选择转诊原因(主观/客观)的影响因素.方法 2012年8月1日至2013年5月31日院间转诊的602例重症患儿为研究对象,采用转诊调查量表收集患儿人口学特征、转诊原因、疾病类型和严重程度等资料,应用SAS 9.2软件对所有资料进行频数分析、x2检验、多因素Logistic回归分析.结果 47.17％(284/602例)院间转诊患儿由于主观原因转诊.不同年龄段患儿因主观/客观转诊原因转诊的比例存在差异(x2=81.10,P＜0.001).入住重症监护室因主观原因转诊的比例(43.67％)低于普通儿科病房(57.21％),差异有统计学意义(x2=23.47,P＜0.001).非三级医院因主观原因选择转诊的比例(40.08％)低于三级医院(52.65％),差异有统计学意义(x2=9.38,P=0.002).危重型患儿因客观原因选择转诊比例(39.44％)高于非危重型(65.91％),差异有统计学意义(x2=35.02,P＜0.001).经多因素Logistic回归分析,转出医院级别、转出科室和疾病严重程度是影响家属主观选择转诊的危险因素(P＜0.05).结论 47.17％的院间转诊患儿因主观原因选择转诊,转出医院级别、转出科室和疾病严重程度是影响家属主观选择转诊的危险因素.
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