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The impact of true partnership between a university Level I trauma center and a community Level II trauma center on patient transfer practices. 1998

W Schwab, and H L Frankel, and M F Rotondo, and D A Gares, and E A Robison, and R M Haskell, and W S Hoff, and D R Kauder, and J Thornton
University of Pennsylvania, Philadelphia, USA.

OBJECTIVE To examine the effect of a clinical and administrative partnership with an academic urban Level I trauma center on the patient transfer practices at a suburban/rural Level II center. METHODS Data for 2 years before affiliation (PRE) abstracted from inpatient charts and the trauma registry were compared with that for 2 years after (POST). The following data were collected: number of, reason for, and destination and demographics of transfers. Chi(2) test and t test analyses were used; p < 0.05 defined significance; data are mean +/- SEM. RESULTS Transfer rate increased from 4% PRE to 6.9% (p = 0.001) POST with no significant difference in age, Glasgow Coma Scale score, Injury Severity Score, or Revised Trauma Score. Repatriation occurred in 12.8% POST (none PRE). The current Level I facility accepted 1.8% of all transfers PRE and 36.4% POST (p = 0.0001). PRE/POST rates by reason are as follows: pediatric, 14.6%/9.0% (p = 0.04); intensive care unit, 0.4%/1.7% (p = 0.13); complex orthopedic, 100%/0% (p = 0.005); vascular, 50%/0% (p = 0.008); spinal cord injury, 100%/100%; and ophthalmologic, 0%/100% (p = 0.005). CONCLUSIONS In this experience of Level I/II partnership (1) transfer patterns were altered, (2) select patient cohort transfers decreased (pediatric, complex orthopedic, vascular), whereas others increased (aortic work-up), and (3) repatriation rates were low.

UI MeSH Term Description Entries
D007373 Interinstitutional Relations The interactions between representatives of institutions, agencies, or organizations. Interagency Relations,Interagency Relation,Interinstitutional Relation,Relation, Interagency,Relation, Interinstitutional,Relations, Interagency,Relations, Interinstitutional
D010360 Patient Transfer Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided. Patient Dumping,Care Transition,Health Care Transition,Patient Transition,Patient Turfing,Transition of Care,Care Transition, Health,Care Transitions,Care Transitions, Health,Dumping, Patient,Health Care Transitions,Patient Transfers,Patient Transitions,Patient Turfings,Transfer, Patient,Transfers, Patient,Transition, Care,Transition, Health Care,Transition, Patient,Transitions, Care,Transitions, Health Care,Transitions, Patient,Turfing, Patient,Turfings, Patient
D010414 Pennsylvania State bounded on the north by New York and Lake Erie, on the east by Delaware and New Jersey, on the south by Delaware and Maryland, and on the west by Ohio and West Virginia.
D011785 Quality Assurance, Health Care Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D012040 Regional Health Planning Planning for health resources at a regional or multi-state level. Annual Implementation Plans,Appropriateness Review,Areawide Planning,Comprehensive Health Planning,Review, Appropriateness,Annual Implementation Plan,Appropriateness Reviews,Health Planning, Comprehensive,Health Planning, Regional,Implementation Plan, Annual,Implementation Plans, Annual,Plan, Annual Implementation,Planning, Areawide,Planning, Comprehensive Health,Planning, Regional Health,Plans, Annual Implementation,Reviews, Appropriateness
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D006764 Hospitals, Community Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area. Community Hospital,Community Hospitals,Hospital, Community
D006785 Hospitals, University Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research. University Hospitals
D006786 Hospitals, Urban Hospitals located in metropolitan areas. City Hospitals,Hospitals, City,Hospitals, City, Non-Public-Owned,Hospitals, Metropolitan,Urban Hospitals,City Hospitals, Non-Public-Owned,Metropolitan Hospitals,Non-Public-Owned City Hospitals,City Hospital,City Hospital, Non-Public-Owned,City Hospitals, Non Public Owned,Hospital, City,Hospital, Metropolitan,Hospital, Non-Public-Owned City,Hospital, Urban,Hospitals, Non-Public-Owned City,Metropolitan Hospital,Non Public Owned City Hospitals,Non-Public-Owned City Hospital,Urban Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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