Abstract
A tertiary care hospital established a transfer cen ter to manage the large number of transfer requests from other hospitals in its catchment region. Moti vating factors included occurrence of economic trans fers, medically inappropriate transfers, poor inter facility communication, and a bed shortage.
An interdisciplinary task force was convened to design and implement the transfer center, requiring two months from conception to implementation. Non- recurring direct costs were $3000. At the time of implementation, written transfer agreements were promoted and signed with many transferring hospi tals.
A retrospective audit covering 28 weeks of opera tion indicates that 1141 inpatient days were avoided for an average of 21.5 days per back-transferred patient. (Back-transfer refers to the return of a pa tient to the original hospital.) An additional 140 ad missions were possible as a result of these avoided days. Approximately $550,000 in variable costs were saved on an annualized basis. Moreover, substantial improvements in communications and interfacility cooperation were realized. No cases of inappropriate denials or delays in transfer were identified.
We conclude that a transfer center can be a highly cost-effective mechanism to manage the large number of patients transferred to a tertiary care center.
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