Sociodemographic determinants in the hospitalization decision: evaluation of an emergency department interhospital transfer policy

Abstract

Study objectives: To evaluate an emergency department's "treat and transfer" policy during a two-month period of reduced inpatient capacity by determining the number and characteristics of transferred patients not admitted as planned to the receiving hospital.

Design: Matched case-control analysis.

Setting: Public hospital adult ED.

Type of participants: Patients transferred to other hospitals for admission.

Interventions: None.

Measurements and main results: Twelve percent of patients (16 of 135) were not admitted after transfer during the first month, and 8% during the two-month period. Only IV drug use was found to be significantly associated with an increased risk of discharge without admission (odds ratio = 9.5; 95% confidence interval, 1.9 to 47.8).

Conclusion: Patients transferred from the public hospital ED resulted in admission to the receiving hospital in 92% of transfers. A history of IV drug use was the only characteristic found to be associated with discharge without admission to the accepting hospital.