What are the incidence and costs associated with interfacility emergency department transfer patients treated by oral and maxillofacial surgeons?

Abstract

ObjectiveInterfacility emergency department transfers (IET) for maxillofacial trauma and infections are prevalent in the US, with significant implications for healthcare costs. Limited availability of oral and maxillofacial surgeons (OMS) exacerbates unnecessary transfers and associated expenses. This study aimed to determine the incidence and costs of OMS IET. Study designA retrospective cohort study was performed for maxillofacial trauma and infection IET at the University of Illinois Health main hospital via electronic medical record query for terms “infection [or] trauma [and] transfer”. Inclusion criteria required presentation 01/01/22 to 06/30/22; ED-ED transfer; consultation by OMS. Distance transferred, insurance type, location of treatment, weekend presentation, and associated costs were collected. Results1,099 records were identified, including 46 trauma IET and 122 infection IET. Costs ranged from $2,683,918.90 to $7,984,912.89, indicating ∼$1.5 billion annual expenditure across US OMS programs. Three trauma IET required urgent treatment; no infection IET were "emergent." Trauma IET averaged 20.7+17.1 miles and infection IET 22.0+17.4 miles for transfer distance. Among trauma IET, 28 were treated in the OR, 10 had outpatient follow-up, and 8 ED treatment. Among infection IET, 57 received ED treatment, 56 OR treatment, and 9 received antibiotics/no treatment. ConclusionsMaxillofacial trauma and infection IET impose significant healthcare costs. Increased funding for OMS training may mitigate the shortage and improve patient care. Further research is needed for better triaging and reimbursement strategies.