Inter-hospital lateral transfer does not increase length of stay.

Abstract

The aim of the present study was to assess the effect of an inter-hospital transfer on efficiency and quality of in-patient care. A retrospective cohort study from 2010 to 2012 inclusive was conducted in two tertiary-referral urban hospitals within a single area healthcare network. The study included 14 571 acutely unwell patients admitted to a general medical service. The main outcome measures were length of in-patient stay, relative stay index, readmission rate within 7 and 28 days of discharge and in-hospital mortality rate. Compared with patients who were transferred to a long-stay ward within the original hospital (n = 3465), transferred patients (n = 1531) were older (71 vs 80 years, respectively; P < 0.001) but suffered less comorbidity (Charlson index 0.84 vs 1.22, respectively; P < 0.001). Transferred patients spent a shorter time in hospital (5.69 vs 6.25 days; P < 0.001) and were less likely to be re-admitted within 7 days (1.5% vs 4.0%; P < 0.001) or 28 days (6.3% vs 9.3%; P < 0.001) than patients who were not transferred. Mortality was lower in the transferred patients (1.1% vs 4.1%). Appropriate patients for inter-hospital transfer can be selected within 24 h of arrival at an index hospital. The efficiency of their care at the receiving hospital appears not to be compromised. The present study provides support for inter-hospital transfer as a strategy to optimise regional bed capacity.