Hospital Over-triage Needlessly Expensive

SAN DIEGO, Sept. 10 (UPI) — “Secondary over-triage,” in which patients are transferred twice and discharged from a second facility in less than 24 hours is costly, U.S. researchers say.

Hayley Osen, research analyst at the University of California, San Diego, and colleagues say “primary over-triage” refers to the transport of patients from the field to hospitals while “secondary over-triage” refers to the transport of patients between hospitals, involving the decision making of hospital-based medical personnel.


The paper, published in The Journal of Trauma, finds 20 percent of pediatric patients were discharged within 24 hours after transfer to a second facility. The average cost of a patient who faces secondary over-triage is $5,917.

“By looking at the number of times patients are transferred, we can evaluate the overall efficiency of our trauma system and its impact on healthcare costs,” Osen says in a statement.

Rapid discharge after transfer was defined as discharge within 24 hours of patients who did not receive a surgical procedure.

However, David Chang, director of the UCSD Center for Surgical Systems and Public Health, says if patients were discharged within 24 hours it is unlikely they needed to be transferred in the first place.

“The paper highlights the issue of defensive medicine,” Chang says. “We found that pediatric patients are most prone to secondary over-triage, which may be due to physicians or hospitals being overly cautious for fear of legal repercussions.”

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