Contact email

smueller1@bwh.harvard.edu

Overview

The team evaluated the association between IHT and healthcare utilization and clinical outcomes to find that inter hospital transfer was associated with higher costs, longer length of stay, and lower odds of discharge home. However, the association between transfer and odds of early death and 30-day mortality depended on the patient’s disease category.

Department

Medicine

Collaborators

Stephanie Mueller
Jie Zheng
Endel John Orav PhD
Jeffrey L Schnipper

Status/Stage of Development

Completed

Measurement

Cost of hospitalization, length of stay, discharge home, 3 day and 30 day mortality

Results

-Looked at a cohort of 53,420 transferred patients and 53,420 propensity-score matched non-transferred patients
-Interhospital transfer was associated with significantly higher costs, longer length of stay, and lower odds of discharge home in all disease categories.
-Interhospital transfer was associated with lower propensity matched odds of 3 day and/or 30 day mortality for the following disease categories: acute myocardial infarction, stroke, sepsis, respiratory disease
-Interhospital transfer was associated with higher propensity matched odds of 3 day and/or 30 day mortality for the following disease categories: esophageal/gastrointestinal disease, renal failure, CHF, pneumonia, renal failure, COPD, hip fracture/dislocation, UTI, and metabolic disease

Major Project Needs

• None

Sources

Mueller S, Zheng J, Orav EJ, Schnipper JL. Inter-hospital transfer and patient outcomes: a retrospective cohort study. BMJ Qual Saf. 2019 Nov;28(11):e1. doi: 10.1136/bmjqs-2018-008087. Epub 2018 Sep 26.