Accuracy of inter-hospital transfer information in Australian hospital administrative databases

Abstract

Inter-hospital transfers improve care delivery for which sending and receiving hospitals both accountable for patient outcomes. We aim to measure accuracy in recorded patient transfer information (indication of transfer and hospital identifier) over 2 years across 121 acute hospitals in New South Wales, Australia. Accuracy rate for 127,406 transfer-out separations was 87 per cent, with a low variability across hospitals (10% differences); it was 65 per cent for 151,978 transfer-in admissions with a greater inter-hospital variation (36% differences). Accuracy rate varied by departure and arrival pathways; at receiving hospitals, it was lower for transfer-in admission via emergency department (incidence rate ratio = 0.52, 95% confidence interval: 0.51-0.53) versus direct admission. Transfer-out data were more accurate for transfers to smaller hospitals (incidence rate ratio = 1.06, 95% confidence interval: 1.03-1.08) or re-transfers (incidence rate ratio > 1.08). Incorporation of transfer data from sending and receiving hospitals at patient level in administrative datasets and standardisation of documentation across hospitals would enhance accuracy and support improved attribution of hospital performance measures.

Blockchain Revolutionizing in Emergency Medicine: A Scoping Review of Patient Journey through the ED

“…Some hospital trusts still rely on paper records, in-house-developed electronic health record (EHR) systems, or disparate electronic systems. The lack of secure and transparent personal health data poses concerns, considering that effective IHTs are integral to improving access, reducing costs, and allocating resources appropriately within healthcare systems [ 94 ].…”

Factors influencing interhospital transfer delays in emergency general surgery: a systematic review and narrative synthesis

“…As pointed out by Assareh et al in 2019, information for transferred patients in hospital administrative datasets in New South Wales, Australia, were inaccurate and interpretation of data could be significantly biased because of varying levels of inaccuracies across hospitals. 31 Harl et al critically assessed written communication provided during interhospital transfers to the emergency department in the US and found 42.5% contained incomplete documentation that was necessary for clinical assessment. 28 Proposed solution to this by Assareh et al was data linkage at patient level across facilities and regions and recognition of patient journey in an integrated data platform combined with standardization of documentation across hospitals with enhanced accuracy of routinely collected datasets.…”

“…28 Proposed solution to this by Assareh et al was data linkage at patient level across facilities and regions and recognition of patient journey in an integrated data platform combined with standardization of documentation across hospitals with enhanced accuracy of routinely collected datasets. 31 Such a system may not be feasible for a single research team to implement without the assistance of organizational or governmental support, however short term prospective data collection could be trialled in a single specialty to gain insight into amount of data, level of detail and manpower required. Study size, duration and power will depend on what the observed frequency of interhospital transfers are and how often transfer delays occur in a region, state or country.…”

“…As pointed out by Assareh et al . in 2019, information for transferred patients in hospital administrative datasets in New South Wales, Australia, were inaccurate and interpretation of data could be significantly biased because of varying levels of inaccuracies across hospitals 31 . Harl et al .…”

The Big Move: Five Mass Transport To Ankara City Hospital

“…IHT is usually performed for acute patients in need of critical care or advanced intervention. There is a need for establishing IHT as regional intensive care centers, centralize certain surgical procedures, and perform certain therapeutic interventions only in certain centers (1)(2)(3)(4).…”