Varied Impacts and Destination Choices of Different Interhospital Transfer Types

摘要

We first differentiate between clinical transfer and non-clinical transfer based on their varied coordination properties, and develop a practical method to separate the two transfer types using patient-level discharge data. We evaluate the impacts of the two transfer types on care outcomes (measured by readmission, mortality, and LOS). Our analysis yields two major findings. First, clinical transfers are more routinized and are associated with better care outcomes than non-clinical transfers. Second, transfer destination choices matter differently for the two transfer types. Specifically, for non-clinical transfers, destinations within the same multihospital system are associated with better care outcomes than those out of the system, whereas for clinical transfers, destinations out of the system are associated with better care outcomes than those in the system. The robustness of the models are checked using propensity score matching techniques. The results shed light on the nature of the two different transfer types, and provide practical destination choice strategies to practitioners.