Sociodemographic determinants in the hospitalization decision: evaluation of an emergency department interhospital transfer policy.
OBJECTIVE
To evaluate an emergency department's "treat and transfer" policy during a two-month period of reduced inpatient capacity by determining the number and characteristics of transferred patients not admitted as planned to the receiving hospital.


METHODS
Matched case-control analysis.


METHODS
Public hospital adult ED.


METHODS
Patients transferred to other hospitals for admission.


METHODS
None.


RESULTS
Twelve percent of patients (16 of 135) were not admitted after transfer during the first month, and 8% during the two-month period. Only IV drug use was found to be significantly associated with an increased risk of discharge without admission (odds ratio = 9.5; 95% confidence interval, 1.9 to 47.8).


CONCLUSIONS
Patients transferred from the public hospital ED resulted in admission to the receiving hospital in 92% of transfers. A history of IV drug use was the only characteristic found to be associated with discharge without admission to the accepting hospital.
Samet
J H
JH
Department of Medicine, Boston University School of Medicine, MA.
Burstin
H R
HR
Green
J
J
Singer
D E
DE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D016022:Case-Control Studies; D002648:Child; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D015276:Health Care Rationing; D006745:Hospital Bed Capacity, 300 to 499; D006773:Hospitals, Municipal / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D010343:Patient Admission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous