Objective The aim of the present study was to assess the effect of an inter-hospital transfer on efficiency and quality of in-patient care. Methods 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 14571 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. Results 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%). Conclusion Appropriate patients for inter-hospital transfer can be selected within 24h 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. What is known about the topic? Little has been written about lateral inter-hospital transfers; it was first labelled a 'sideways transfer' in a publication about hospital reimbursement published in the Medical Journal of Australia in 1998. What does this paper add? This paper adds quality and safety data to what little is known about lateral transfers. 'Lateral transfer' better describes the process than 'sideways transfer'. What are the implications for practitioners? Our data helped us understand that a lateral transfer does not by itself increase the cost of the hospital stay, nor does it increase readmission rate or mortality. It also means that if a patient is hospitalised in a hospital with limited capacity and the patient's acute medical problem has improved, but not resolved, that patient can be safely transferred to a hospital with available beds to continue receiving acute services.
- Inter-hospital transfer
- trauma patients