Adequacy of care during interfacility transfer in Taiwan: A pilot study

Shao Peng Huang, Yu Yuan Lin, Yuh Shin Kuo, Yu Fen Huang, Shu Chun Wu, Kuo Tien Huang, Chien Hsin Lu, Po Wei Chiu, I. Chen Lin, Ying Hsin Chang, Chao Wei Chin, Hung Chieh Chang, Chih Hao Lin

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background/purpose: Interfacility transfer (IFT) in Asian communities is seldom discussed. We aimed to describe the characteristics of IFT in Taiwan and to explore the adequacy of care during transfer. Methods: A retrospective, cross-sectional, descriptive study was conducted using standardized, paper-based interfacility ambulance transfer records between 1 January 2018 and 31 January 2018 from Tainan City, Taiwan. The mode of patient care needed was classified as advanced life support (ALS) or basic life support (BLS) cares based on clinical conditions. ALS providers were defined as physicians and EMT-Paramedics, while BLS providers were defined as nurse practitioners, nurses, EMT-1s and EMT-2s. Results: Of the 377 (227 [60.2%] were >65 years old; 219 [58.1%] were male) IFTs enrolled in the final analysis, 210 (55.7%) patients met the ALS transfer criteria, with poor consciousness (n = 158), tachypnea (n = 17), tachycardia (n = 5), bradycardia (n = 7), hypertension (n = 12), hypotension (n = 13), hypoxia (n = 4), endotracheal intubation (n = 18), a tracheostomy (n = 25), a precipitous labor (n = 1), and after resuscitation for out-of-hospital cardiac arrest (n = 10) or in-hospital cardiac arrest (n = 3). None of the patients who required ALS care had adequate ambulance staffing. Of the 167 BLS IFTs, 9 (5.4%) patients deteriorated and required ALS care during transportation, which included worsened consciousness (n = 2), tachycardia (n = 1), hypertension (n = 2), hypotension (n = 1), and hypoxia (n = 3). The rates of deterioration during BLS-transferals from the emergency departments, general wards, nursing facilities, and unknown areas were 4.8%, 4.7%, 7.7%, and 7.1%, respectively (p = 0.93). Conclusion: The patient care during IFT in Taiwan is inadequate currently and should warrant attention.

Original languageEnglish
Pages (from-to)1864-1871
Number of pages8
JournalJournal of the Formosan Medical Association
Issue number9
Publication statusPublished - 2022 Sept

All Science Journal Classification (ASJC) codes

  • General Medicine


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