Characteristics and outcomes of emergency interhospital transfers from subacute to acute care for clinical deterioration

Considine, Julie-Anne, Street, Maryann, Bucknall, Tracey, Rawson, Helen, Hutchison, Anastasia F, Dunning, Patricia, Botti, Mari, Duke, Maxine, Mohebbi, Mohammadreza and Hutchinson, Alison 2018, Characteristics and outcomes of emergency interhospital transfers from subacute to acute care for clinical deterioration, International journal for quality in health care, pp. 1-8, doi: 10.1093/intqhc/mzy135.

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Title Characteristics and outcomes of emergency interhospital transfers from subacute to acute care for clinical deterioration
Author(s) Considine, Julie-AnneORCID iD for Considine, Julie-Anne orcid.org/0000-0003-3801-2456
Street, MaryannORCID iD for Street, Maryann orcid.org/0000-0002-5615-141X
Bucknall, TraceyORCID iD for Bucknall, Tracey orcid.org/0000-0001-9089-3583
Rawson, HelenORCID iD for Rawson, Helen orcid.org/0000-0001-5363-729X
Hutchison, Anastasia F
Dunning, PatriciaORCID iD for Dunning, Patricia orcid.org/0000-0002-0284-1706
Botti, MariORCID iD for Botti, Mari orcid.org/0000-0002-2782-0987
Duke, MaxineORCID iD for Duke, Maxine orcid.org/0000-0003-1567-3956
Mohebbi, MohammadrezaORCID iD for Mohebbi, Mohammadreza orcid.org/0000-0001-9713-7211
Hutchinson, AlisonORCID iD for Hutchinson, Alison orcid.org/0000-0001-5065-2726
Journal name International journal for quality in health care
Start page 1
End page 8
Total pages 8
Publisher Oxford University Press
Place of publication Oxford, Eng.
Publication date 2018-06-20
ISSN 1464-3677
Keyword(s) patient outcomes
health status
quality of life
mortality
measurement of quality
adverse events
patient safety
risk management
readmissions
complications
elderly
specific populations
Summary Objective: To describe characteristics and outcomes of emergency interhospital transfers from subacute to acute hospital care and develop an internally validated predictive model to identify features associated with high risk of emergency interhospital transfer. Design: Prospective case-time-control study. Setting: Acute and subacute healthcare facilities from five health services in Victoria, Australia. Participants: Cases were patients with an emergency interhospital transfer from subacute to acute hospital care. For every case, two inpatients from the same subacute care ward on the same day of emergency transfer were randomly selected as controls. Admission episode was the unit of measurement and data were collected prospectively. Main outcome measures: Patient and admission characteristics, transfer characteristics and outcomes (cases), serious adverse events and mortality. Results: Data were collected for 603 transfers in 557 patients and 1160 control patients. Cases were significantly more likely to be male, born in a non-English speaking country, have lower functional independence, more frequent vital sign assessments and experience a serious adverse event during first acute care or subacute care admissions. When adjusted for health service, cases had significantly higher inpatient mortality, were more likely to have unplanned intensive care unit admissions and rapid response team calls during their entire hospital admission. Conclusions: Patients who require an emergency interhospital transfer from subacute to acute hospital care have hospital admission rates and in-hospital mortality. Clinical instability during the first acute care admission (serious adverse events or increased surveillance) may prompt reassessment of patient suitability for movement to a separate subacute care hospital.
Notes In press
Language eng
DOI 10.1093/intqhc/mzy135
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
111004 Clinical Nursing: Tertiary (Rehabilitative)
Socio Economic Objective 920210 Nursing
Copyright notice ©2018, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30109906

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