Mortality of patients transferred to a tertiary care hospital

Abstract

Background: Seriously ill patients are often transferred from community hospitals to tertiary care hospitals.

Objectives: To review the numbers, sources, and outcomes of patients transferred to the Cleveland Clinic Hospital from 1989 through 1992.

Methods: Retrospective analysis.

Results: Compared with the Cleveland Clinic's overall hospital mortality rate of 3.09% (3760 of 121,014 patients) during this period, the mortality rate among transferred patients was 8.26% (1092 of 13,226 patients). Although transferred patients accounted for only 10.9% of the total admissions, they represented 29.0% of the deaths. Transfers from other hospitals in the Cleveland Health Quality Choice (HQC) program, a community-wide quality-assessment project, increased 40.2% in 1992 (during the initial data collection period for the HQC program), while those from non-HQC hospitals increased only 0.9%.

Conclusions: Patients transferred to a tertiary care hospital from other acute care hospitals have a 2.7-fold greater chance of dying in the hospital than nontransferred patients. Public scrutiny of quality may increase the likelihood of transfer of seriously ill patients to tertiary care centers.