The following is a summary of “Analysis of health inequities in transfers of admitted patients from an academic emergency department to partner community hospital,” published in the January 2024 issue of Emergency Medicine by Lee, et al.
Transferring patients from academic medical centers (AMCs) to community hospitals is common but may contribute to healthcare disparities. For a study, researchers sought to assess disparities in transferring patients from an AMC ED to a community hospital General Medical Service.
They conducted a retrospective cohort study on patients screened for transfer between April 1 and December 31, 2021. Treating ED physicians determined a coordinator obtained transfer eligibility based on standardized criteria, and patient consent. Patient demographic data were collected from electronic health records, and logistic regression was performed to analyze the impact of individual characteristics on transfer odds at each stage.
Out of 5,558 screened patients, 596 (11%) were transferred. Among them, 1999 (36%) were Black or Hispanic, 698 (12%) had a non-English preferred language, and 956 (17%) were Medicaid/uninsured. A higher proportion of Black (36%) and Hispanic (37%) patients were eligible for transfer compared to White patients (26%), and more Hispanic patients (15%) completed transfer compared to Black (12%) and White (10%) patients (P < 0.017 after Bonferroni correction). After adjusting for demographic variables, patients older than 50 (OR 1.21, 95% CI 1.04–1.40), with a non-English preferred language (OR 1.27, 95% CI 1.00–1.62), and from priority neighborhoods (OR 1.38, 95% CI 1.18–1.61) were more likely to be eligible for transfer, while males (OR 1.50, 95% CI 1.10–2.05) and those younger than 50 (OR 1.85, 95% CI 1.20–2.78) were more likely to consent to transfer (P < 0.05).
Disparities exist in the interfacility transfer screening process, warranting further investigation into their causes and the implementation of mitigation strategies.
Reference: sciencedirect.com/science/article/abs/pii/S0735675723006010
