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Potentially avoidable inter-hospital transfer for gynaecology consultation at a tertiary care centre: a retrospective study.
Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology 2018 September 20
Inter-hospital transfers for consultation are common and costly in the USA. Our objective was to evaluate the inter-hospital transfers between the emergency departments (ED) for a gynaecology consultation and to identify markers for potentially avoidable transfers. We performed a retrospective chart review of all transfers accepted by a tertiary care hospital gynaecology service via the ED over two years. Our primary outcome was the designation of the transfer as 'potentially avoidable', defined as a patient discharged home directly from the ED, with no workup or treatment prior to their discharge. The Chi-square tests were used to assess what patient characteristics and medical diagnoses are associated with potentially avoidable transfers. Of 156 patients meeting the inclusion criteria, a total of 38 (24.4%) were potentially avoidable transfers. Women with potentially avoidable transfers were more likely to be pregnant than those whose transfers were necessary (63.2% vs. 40.7% p = .02), and more likely to specifically have a pregnancy of unknown location (PUL) or a complete abortion (p < .01).
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