The aim of this descriptive study was to establish and describe the national incidence, cost, and outcomes of patients that undergo medical transfer. Using discharge data from the Nationwide Inpatient Sample 2011, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, the dataset was analyzed using weighted frequency distribution. Approximately 1.6 million patients are transferred yearly. Transferred patients experience a mean length of stay of 9.3 days (std dv 13.5) versus 4.3 days for patients not transferred (std dv 6.0), and cost more than twice as much (mean $19,234) versus those not transferred (mean $9,469). Additionally, patients who undergo inter-facility transfer cost an additional $15.8 billion annually. Interhospital patient transfers require closer scrutiny regarding appropriateness and future policy implications.
AustinP. C. (2011). An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. Multivariate Behav Res, 46(3), 399–424. doi: 10.1080/00273171.2011.568786.
2.
BazzoliG. J. (2010). Pulling the Pieces Together: Consolidation and Integration in Health Care Systems Retrieved February 24, 2014, from http://www.hret.org/resources/4810008139.
3.
ConroyM. B., RodriguezS. U., KimmelS. E., & KasnerS. E. (1999). Helicopter transfer offers a potential benefit to patients with acute stroke. Stroke, 30(12), 2580–2584.
4.
DurairajL., WillJ. G., TornerJ. C., & DoebbelingB. N. (2003). Prognostic factors for mortality following interhospital transfers to the medical intensive care unit of a tertiary referral center. Crit Care Med, 31(7), 1981–1986. doi: 10.1097/01.CCM.0000069730.02769.16.
5.
ElixhauserA., SteinerC., HarrisD. R., & CoffeyR. M. (1998). Comorbidity measures for use with administrative data. Med Care, 36(1), 8–27.
6.
FosbolE. L., GrangerC. B., JollisJ. G., MonkL., LinL., LytleB. L., … GlickmanS. W., (2012). The Impact of a Statewide Pre-Hospital STEMI Strategy to Bypass Hospitals without Percutaneous Coronary Intervention Capability on Treatment Times. Circulation. doi: 10.1161/CIRCULATIONAHA.112.118463.
7.
GalvagnoS. M.Jr., HautE. R., ZafarS. N., MillinM. G., EfronD. T., KoenigG. J.Jr., … HaiderA. H. (2012). Association between helicopter vs ground emergency medical services and survival for adults with major trauma. JAMA, 307(15), 1602–1610. doi: 10.1001/jama.2012.467.
8.
GrinesC. L., WesterhausenD. R.Jr., GrinesL. L., HanlonJ. T., LogemannT. L., NiemelaM., … AirP. S. G. (2002). A randomized trial of transfer for primary angioplasty versus on-site thrombolysis in patients with high-risk myocardial infarction: the Air Primary Angioplasty in Myocardial Infarction study. J Am Coll Cardiol, 39(11), 1713–1719.
HillA. D., VingilisE., MartinC. M., HartfordK., & SpeechleyK. N. (2007). Interhospital transfer of critically ill patients: demographic and outcomes comparison with nontransferred intensive care unit patients. J Crit Care, 22(4), 290–295. doi: S0883-9441(07)00086-X [pii]10.1016/j.jcrc.2007.06.002.
RosenbergA. L., HoferT. P., StrachanC., WattsC. M., & HaywardR. A. (2003). Accepting critically ill transfer patients: adverse effect on a referral center's outcome and benchmark measures. Ann Intern Med, 138(11), 882–890. doi: 200306030-00009 [pii].
15.
SilbergleitR., ScottP. A., & LowellM. J. (2003). Cost-effectiveness of helicopter transport of stroke patients for thrombolysis. Acad Emerg Med, 10(9), 966–972.
16.
van WalravenC., AustinP. C., JenningsA., QuanH., & ForsterA. J. (2009). A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data. Med Care, 47(6), 626–633. doi: 10.1097/MLR.0b013e31819432e5.
