Impact of Interhospital Transfer on Acute Myocardial Infarction Outcomes
Author Information
Author(s): John M Westfall, Catarina I Kiefe, Norman W Weissman, Anthony Goudie, Robert M Centor, O Dale Williams, Jeroan J Allison
Primary Institution: University of Colorado Denver – Anschutz Medical Campus
Hypothesis
Does interhospital transfer improve outcomes for patients with acute myocardial infarction?
Conclusion
Transferred patients had lower mortality than non-transferred patients, and mortality was similar in rural and urban hospitals.
Supporting Evidence
- 28% of patients underwent interhospital transfer.
- Transferred patients were significantly younger and less critically ill.
- After matching, transferred patients had better quality of care.
- Mortality rates were similar in rural and urban hospitals.
Takeaway
When patients with heart attacks are moved from one hospital to another, they tend to do better and live longer than those who stay at the same hospital.
Methodology
Retrospective analysis of Medicare patients with acute myocardial infarction using propensity score matching.
Potential Biases
Potential confounding and selection bias due to non-random assignment of transfer status.
Limitations
Transfer and rural hospitalization were not randomly assigned, and observational studies may introduce bias.
Participant Demographics
Patients included were primarily Medicare patients, with a significant proportion being older and having various comorbid conditions.
Statistical Information
P-Value
0.007
Confidence Interval
0.76–0.84
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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