Impact of a transfer center on interhospital referrals and transfers to a tertiary care center

Patricia Southard, Jerris R. Hedges, John Hunter, Ross M. Ungerleider

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: The partnership of faculty physicians and senior clinical hospital administrators in the decision to accept interhospital transfers has not been fully studied. Transfers to academic medical centers on the basis of economics have been of particular concern. Objectives: To evaluate the impact of joint decision making on transfer acceptance, and to evaluate the basis for decisions to transfer patients to an academic medical center. Methods: This was a database study of requested adult interhospital transfers, excluding psychiatric transfers, occurring between January 1, 2003, and December 31, 2003, by using data from a computerized patient-tracking system. Where possible, comparisons with the prior calendar year (i.e., prior to implementation of the administrative review process) were made. Incidence of refusal to accept requested transfers and payer mix of transfer patients were the main outcomes of interest. Results: More than 90% of the adult patients were transferred for conditions that required tertiary care or met Emergency Medical Treatment and Labor Act (EMTALA) requirements. The patient conditions that did not meet tertiary care needs included obstetric patients who did not have prenatal care, patients who had hand and facial trauma, and patients who weighed more than 300 pounds. The payer mix of transfer patients remained stable when using the administrator and physician team to determine acceptance of transfers. During the evaluation period, approximately 91,500 patients statewide lost some level of Medicaid coverage. Conclusions: The value of an administrator and physician team as partners in the interhospital transfer process was demonstrated. Active management of interhospital transfers supports transfer of patients who require tertiary care or who meet EMTALA criteria, thus conserving limited bed capacity and ensuring financial equity, while caring for the uninsured and underinsured patients throughout the state.

Original languageEnglish (US)
Pages (from-to)653-657
Number of pages5
JournalAcademic Emergency Medicine
Volume12
Issue number7
DOIs
StatePublished - Jul 2005

Fingerprint

Tertiary Care Centers
Referral and Consultation
Patient Transfer
Tertiary Healthcare
Emergency Treatment
Administrative Personnel
Physicians
Patient Identification Systems
Hospital Administrators
Prenatal Care
Medicaid
Obstetrics
Psychiatry
Decision Making
Hand
Economics
Databases
Incidence
Wounds and Injuries

Keywords

  • Administration
  • Decision making
  • Interhospital
  • Transfer
  • Transfer center

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Impact of a transfer center on interhospital referrals and transfers to a tertiary care center. / Southard, Patricia; Hedges, Jerris R.; Hunter, John; Ungerleider, Ross M.

In: Academic Emergency Medicine, Vol. 12, No. 7, 07.2005, p. 653-657.

Research output: Contribution to journalArticle

@article{3def0f70a8c7460dbcb9220bed315d8f,
title = "Impact of a transfer center on interhospital referrals and transfers to a tertiary care center",
abstract = "Background: The partnership of faculty physicians and senior clinical hospital administrators in the decision to accept interhospital transfers has not been fully studied. Transfers to academic medical centers on the basis of economics have been of particular concern. Objectives: To evaluate the impact of joint decision making on transfer acceptance, and to evaluate the basis for decisions to transfer patients to an academic medical center. Methods: This was a database study of requested adult interhospital transfers, excluding psychiatric transfers, occurring between January 1, 2003, and December 31, 2003, by using data from a computerized patient-tracking system. Where possible, comparisons with the prior calendar year (i.e., prior to implementation of the administrative review process) were made. Incidence of refusal to accept requested transfers and payer mix of transfer patients were the main outcomes of interest. Results: More than 90{\%} of the adult patients were transferred for conditions that required tertiary care or met Emergency Medical Treatment and Labor Act (EMTALA) requirements. The patient conditions that did not meet tertiary care needs included obstetric patients who did not have prenatal care, patients who had hand and facial trauma, and patients who weighed more than 300 pounds. The payer mix of transfer patients remained stable when using the administrator and physician team to determine acceptance of transfers. During the evaluation period, approximately 91,500 patients statewide lost some level of Medicaid coverage. Conclusions: The value of an administrator and physician team as partners in the interhospital transfer process was demonstrated. Active management of interhospital transfers supports transfer of patients who require tertiary care or who meet EMTALA criteria, thus conserving limited bed capacity and ensuring financial equity, while caring for the uninsured and underinsured patients throughout the state.",
keywords = "Administration, Decision making, Interhospital, Transfer, Transfer center",
author = "Patricia Southard and Hedges, {Jerris R.} and John Hunter and Ungerleider, {Ross M.}",
year = "2005",
month = "7",
doi = "10.1197/j.aem.2005.03.515",
language = "English (US)",
volume = "12",
pages = "653--657",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Impact of a transfer center on interhospital referrals and transfers to a tertiary care center

AU - Southard, Patricia

AU - Hedges, Jerris R.

AU - Hunter, John

AU - Ungerleider, Ross M.

PY - 2005/7

Y1 - 2005/7

N2 - Background: The partnership of faculty physicians and senior clinical hospital administrators in the decision to accept interhospital transfers has not been fully studied. Transfers to academic medical centers on the basis of economics have been of particular concern. Objectives: To evaluate the impact of joint decision making on transfer acceptance, and to evaluate the basis for decisions to transfer patients to an academic medical center. Methods: This was a database study of requested adult interhospital transfers, excluding psychiatric transfers, occurring between January 1, 2003, and December 31, 2003, by using data from a computerized patient-tracking system. Where possible, comparisons with the prior calendar year (i.e., prior to implementation of the administrative review process) were made. Incidence of refusal to accept requested transfers and payer mix of transfer patients were the main outcomes of interest. Results: More than 90% of the adult patients were transferred for conditions that required tertiary care or met Emergency Medical Treatment and Labor Act (EMTALA) requirements. The patient conditions that did not meet tertiary care needs included obstetric patients who did not have prenatal care, patients who had hand and facial trauma, and patients who weighed more than 300 pounds. The payer mix of transfer patients remained stable when using the administrator and physician team to determine acceptance of transfers. During the evaluation period, approximately 91,500 patients statewide lost some level of Medicaid coverage. Conclusions: The value of an administrator and physician team as partners in the interhospital transfer process was demonstrated. Active management of interhospital transfers supports transfer of patients who require tertiary care or who meet EMTALA criteria, thus conserving limited bed capacity and ensuring financial equity, while caring for the uninsured and underinsured patients throughout the state.

AB - Background: The partnership of faculty physicians and senior clinical hospital administrators in the decision to accept interhospital transfers has not been fully studied. Transfers to academic medical centers on the basis of economics have been of particular concern. Objectives: To evaluate the impact of joint decision making on transfer acceptance, and to evaluate the basis for decisions to transfer patients to an academic medical center. Methods: This was a database study of requested adult interhospital transfers, excluding psychiatric transfers, occurring between January 1, 2003, and December 31, 2003, by using data from a computerized patient-tracking system. Where possible, comparisons with the prior calendar year (i.e., prior to implementation of the administrative review process) were made. Incidence of refusal to accept requested transfers and payer mix of transfer patients were the main outcomes of interest. Results: More than 90% of the adult patients were transferred for conditions that required tertiary care or met Emergency Medical Treatment and Labor Act (EMTALA) requirements. The patient conditions that did not meet tertiary care needs included obstetric patients who did not have prenatal care, patients who had hand and facial trauma, and patients who weighed more than 300 pounds. The payer mix of transfer patients remained stable when using the administrator and physician team to determine acceptance of transfers. During the evaluation period, approximately 91,500 patients statewide lost some level of Medicaid coverage. Conclusions: The value of an administrator and physician team as partners in the interhospital transfer process was demonstrated. Active management of interhospital transfers supports transfer of patients who require tertiary care or who meet EMTALA criteria, thus conserving limited bed capacity and ensuring financial equity, while caring for the uninsured and underinsured patients throughout the state.

KW - Administration

KW - Decision making

KW - Interhospital

KW - Transfer

KW - Transfer center

UR - http://www.scopus.com/inward/record.url?scp=20444452568&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20444452568&partnerID=8YFLogxK

U2 - 10.1197/j.aem.2005.03.515

DO - 10.1197/j.aem.2005.03.515

M3 - Article

C2 - 15995099

AN - SCOPUS:20444452568

VL - 12

SP - 653

EP - 657

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

SN - 1069-6563

IS - 7

ER -