In-hospital stroke mortality, hospital transfers, and referral bias at a rural academic medical center.
A chart review of acute stroke (DRG 14) discharges from a rural academic medical center in 1999 was performed because of an observed high in-hospital crude acute stroke mortality rate. An analysis of the results of this chart review demonstrated that the odds ratio of intracerebral hemorrhage in patients who had been transferred from other hospitals was 11.7 compared to intracerebral hemorrhage in nonhospital transfer patients (p < 0.00001). This finding illustrates the potential magnitude and significance of referral bias at a rural academic medical center.
Department of Neurology, West Virginia University Health Sciences Center, Morgantown 26506-9180, USA. jriggs@wvu.edu
Jack E
JE
Riggs
David P
DP
Libell
Gerald R
GR
Hobbs
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D005568:Forms and Records Control / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D020521:Stroke / Q000145:classification / Q000401:mortality*; D014903:West Virginia / Q000453:epidemiology