title: [Trends in interhospital transfers from a Swiss university hospital center].
abstract: OBJECTIVE
  Research on interhospital transfers provides a basis for describing and quantifying patient flow and its evolution over time, offering an insight into hospital organization and management and hospital overcrowding. The purpose of this study was to conduct a qualitative and quantitative analysis of patient flow and to examine trends over an eight-year period.
  
  
  METHODS
  A retrospective descriptive study of interhospital transfers was conducted between 2003 and 2011 based on an analysis of demographic, medical and operational characteristics. Ambulance transfers and transfers requiring physician assistance were analyzed separately.
  
  
  RESULTS
  The number of interhospital transfers increased significantly over the study period,from 4,026 in 2003 to 6,481 in 2011 (+60.9%). The number of ambulance transfers increased by almost 300% (616 in 2003 compared to 2,460 in 2011). Most of the transfers (98%) were to hospitals located less than 75 km from the university hospital (median: 24 km, 5-44). In 2011, 24% of all transfers were to psychiatric institutions. 26% of all transfer cases were direct transfers from the emergency department. An increasing number of transfers required physician assistance. 18% of these patients required ventilatory support, whole 9.8% required vasoactive drugs. 11.6% of these transfers were due to hospital overcrowding.
  
  
  CONCLUSIONS
  The study shows that there has been a significant increase in interhospital transfers. This increase is related to hospital overcrowding and to the network-based systems governing patient care strategies.
authors.affiliation: Centre hospitalier universitaire vaudois, rue du Bugnon 46, CH 1011 Lausanne, Suisse. pierre-nicolas.carron@chuv.ch
authors.forename: Pierre-Nicolas
authors.initials: PN
authors.lastname: Carron
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meylan
authors.forename: Bertrand
authors.initials: B
authors.lastname: Yersin
authors.forename: Jean-Blaise
authors.initials: JB
authors.lastname: Wasserfallen
authors.forename: Laurent
authors.initials: L
authors.lastname: Vallotton
mesh_terms: D006785:Hospitals, University; D006801:Humans; D010360:Patient Transfer / Q000706:statistics & numerical data* / Q000639:trends*; D012189:Retrospective Studies; D013557:Switzerland