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Reasons underlying interhospital transfers to an academic medical intensive care unit.

Abstract：

PURPOSE:Interhospital critical care transfers are common, yet few studies address the underlying reasons for transfers. We examined clinician and patient/surrogate perceptions about interhospital transfers and assessed their agreement on these transfers. MATERIALS AND METHODS:This is a mixed-mode survey of 3 major stakeholders in interhospital transfers to an academic medical intensive care unit from August 2007 to April 2008. RESULTS:Sixty-two hospitals transferred 138 patients during the study period. Response rates varied among stakeholders (accepting physician, 90%; referring physicians, 20%; patients/surrogates, 33%). All 3 groups frequently endorsed quality of care and need for a specific test/procedure as important. Referring hospital reputation and quality were rarely endorsed. Accepting physicians and patients/surrogates substantially agreed on the need for a specific test (κ = 0.70) and increased survival (κ = 0.78) but, otherwise, had fair to poor agreement. Referring physicians and patients/surrogates rarely agreed and sometimes disagreed greater than expected by chance (κ < 0). Physician pairs strongly agreed on the importance of accepting hospital experience (κ = 0.96) but agreed less on patient satisfaction at the referring hospital (κ = 0.37) and referring hospital reputation (κ = 0.35). CONCLUSIONS:Stakeholders do not always agree on the reasons for critical care transfers. Efforts to improve communication are warranted to ensure informed patient choices.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Wagner J,Iwashyna TJ,Kahn JM

doi

10.1016/j.jcrc.2012.07.027

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

202-8

issue

2

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(12)00246-8

journal_volume

28

pub_type

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