title: Community hospital transfers to a VA Medical Center.
abstract: We prospectively studied all transfers from community hospitals to the Zablocki Veterans Administration Medical Center in Milwaukee (Wis) between May 28, 1986, and January 1, 1987. Transfers totaled 4.7% (311/6609) of acute-care admissions during the study period but accounted for 19.1% (39/204) of in-hospital deaths. The mortality rate for transferred patients who required Veterans Administration hospitalization was 12.5% (39/311) compared with 2.6% (165/6298) for all other admissions. At the time of transfer 59 patients (19%) were judged unstable by a modification of the APACHE II classification system, yet only 19 patients were cared for en route by a physician or a nurse. In addition to higher mortality, the transferred patients had a longer median length of stay than nontransferred patients (11 days vs 7 days).
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee.
authors.forename: H D
authors.initials: HD
authors.lastname: Kerr
authors.forename: J C
authors.initials: JC
authors.lastname: Byrd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006764:Hospitals, Community; D006787:Hospitals, Veterans / Q000191:economics; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States