Interhospital Patient Transfers from the Emergency Department: A Retrospective, Observational Study

Abstract

Aims: All patients requiring emergency intervention are given their first medical attention in the emergency department, regardless of the facilities, equipment, and occupancy of the hospital. When the hospital facilities are not sufficient, interhospital patient transfers may be done under some regulations and legislations. This study aimed to analyze interhospital patient transfers from emergency departments to other hospitals. Materials and methods: This retrospective, observational, descriptive study examined interhospital patient transfers from İstanbul Emergency Department to other hospitals for four years (2018–2022). While all referrals made by the emergency service through the Arnavutköy State Hospita 112 Provincial Ambulance Service Transport Unit were eligible for the study, patients under the age of 18, those whose referral was due to COVID-19 infection, and those whose data could not be accessed were excluded. In addition to demographic data, interhospital patient transfers were evaluated according to time, department, diagnosis, distance between hospitals, and the characteristics of the referral institution. Results: The study included 4,280 transfers. Transfers were done most frequently in 2018 (1,310; 30.6%). Transfers were often handled outside of weekday daytime (2,919; 68.2%) and were most frequently done for cardiac events (2,592; 60.6%). The average transfer distance between hospitals was calculated as 24.29 km (standard deviation [SD]: 6.55 km), while the mean time between the first registration and the transfer was 344.8 minutes (SD: 275.3 minutes). In the analysis of transfers by year, a higher rate of transfers were to public institutions in each successive year (2018: 40.8%; 2019: 52.4%; 2020: 77.8%; 2021: 78.3%). Conclusion: The most common reason for transfer was cardiac events. Increasing the cardiology facilities and equipment of the hospital could reduce the number of interhospital patient transfers.