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Tracking Non–Burn Center Care: What You Don’t Know May Surprise You

Davis, James S. MD; Dearwater, Stephen PhD; Rosales, Oscar BS; Varas, Robin ARNP; Quintana, Olga D. ARNP; Pizano, Louis MD, MBA; Namias, Nicholas MD, MBA; Schulman, Carl I. MD, PhD, MSPH

doi: 10.1097/BCR.0b013e3182504450
Original Articles

The American Burn Association publishes a list of defined criteria for patients who require admission or transfer to a burn center. This study examines the extent to which those criteria are observed within a regional burn network. Hospital discharge data for 2008 were obtained for all hospitals within the South Florida regional burn network. Patients with International Classification of Diseases, 9th revision discharge diagnoses for burns were reviewed, and their triage destination was compared with the burn triage referral criteria to determine whether patients were inappropriately triaged. Descriptive statistics were used to analyze the data. Four hundred ninety-eight burn admissions were documented to non–burn center center hospitals, 269 (54%) of which were deemed inappropriate by burn triage referral criteria. Burn center patients had greater length of stay when compared with non–burn center patients (14 vs 7 days), but a greater percentage were discharged home for self-care (88 vs 57%). Thirty-three percent of the inappropriate admissions were in a neighboring county, whereas 27% were in the same county where the burn center is located. Inappropriate burn patient triage may be occurring to more than half of the burn patients within our regional burn network despite better functional outcomes at the burn center. This may be because of a lack of knowledge regarding triage criteria, patient insurance status, or other factors. Further studies are necessary to fully characterize the problem and implement education or incentives to encourage appropriate burn patient triage.

From the Division of Burn Care, Jackson Memorial Hospital/University of Miami Burn Center, Miller School of Medicine University of Miami, Florida.

The authors declare no conflict of interest.

Address Correspondence to Carl I. Schulman, MD, PhD, MSPH, Associate Professor of Surgery, Ryder Trauma Center, PO Box 016960 (D-40), Miami, Florida 33136.

© 2012 The American Burn Association