SHM Converge Scientific Abstract ePoster Gallery-Hospital Outcomes of Transfer Center Admits Compared to Emergency Department Admits

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This retrospective Mayo Clinic study (July 2019–June 2021) compared hospital outcomes for patients admitted through a transfer center versus the emergency department (ED) before COVID-19-related diversion in Minnesota. The goal was to determine whether transfer-center admissions had worse outcomes than ED admissions when matched for age, gender, Charlson comorbidity score, and admitting service.<br /><br />A total of 73,707 patients were included overall. After matching, 19,107 patients were in each group. Baseline matching was performed on age, gender, admitting service, and comorbidity burden. Outcomes examined included hospital length of stay (LOS), in-hospital mortality, 30-day mortality, and readmissions. Analyses included chi-square/Kruskal-Wallis testing, conditional logistic regression, and Poisson regression for LOS.<br /><br />In the matched cohort, transfer-center patients had worse outcomes than ED patients:<br />- In-hospital mortality: 2.3% vs 1.9%<br />- 30-day mortality: 5.4% vs 3.9%<br />- Readmissions: 12.8% vs 7.2%<br />- LOS: mean 6.4 vs 5.1 days<br /><br />Conditional logistic regression showed transfer-center admission was associated with higher odds of:<br />- In-hospital mortality (OR 1.18)<br />- 30-day mortality (OR 1.57)<br />- Readmissions (OR 1.89)<br /><br />Longer LOS was also associated with worse outcomes. In unmatched analyses, transfer patients were older, more often male, had higher comorbidity scores, and had longer LOS, with worse mortality and readmission outcomes.<br /><br />The study concluded that transfer-center admits at this tertiary care facility had poorer outcomes than matched ED admits, suggesting that additional benchmarking and future research are needed to explore contributing factors such as transfer acuity, EHR integration, second-opinion transfers, and possible systemic bias.

Asset Subtitle

Sandeep R. Pagali

Meta Tag

Author List James Newman, Karen M. Fischer, M. Caroline Burton, Riddhi S. Parikh, Sandeep R. Pagali

Category Research

Concept Transfer Center Admission

Concept Emergency Department Admission

Concept Mortality

Concept 30-Day Mortality

Concept Matching Process

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Department of Medicine, Mayo Clinic, Rochester, MN

Presenting Author Sandeep R. Pagali

Track Outcomes Research

Keywords

Mayo Clinic

transfer center

emergency department

hospital outcomes

retrospective study

mortality

readmissions

length of stay

Charlson comorbidity score

matched cohort

Transfer Center Admission

Emergency Department Admission

Mortality

30-Day Mortality

Matching Process