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Characterization and Comparison of Transferred and Non-Transferred Patients Admitted to the Acute Care Surgery Service of a Tertiary Care Teaching Hospital
*Brittany Misercola, Jonathan Dreifus
Maine Medical Center, Portland, ME

Objective:
To identify and characterize the patients admitted to the Acute Care Surgery (ACS) service at a tertiary care teaching hospital and compare patients accepted from outside hospitals (transferred patients) to those accepted through the emergency department (non-transferred patients). We hypothesized those patients being transferred would be older, have more comorbidities, and stay longer than non-transferred patients.
Design:
Descriptive, cross sectional study using hospital medical records.
Setting:
Community, tertiary referral teaching hospital in a rural state.
Patients:
Adult patients admitted to the Acute Care Surgery service between January 2014 - December 2014.
Intervention:
None.
Main outcomes measures:
A description of the clinical and demographic characteristics of our acute care surgery patient population.
Results:
A majority of the transfer patients originated from community hospitals affiliated with our medical center with an average distance of 63 miles traveled. Pancreaticobiliary complaints were the most common reason for admission for transferred patients and non-transferred patients, followed by problems associated with the small bowel (ischemia, obstruction). Transfer patients had a longer length of stay, and, as expected, they were older and had more comorbidities. ICU admission was more common in transfer patients. Medicare was the most common insurance for all patients, and the majority of patients were able to be discharged to home.
Conclusions:
Patients accepted in transfer to the Acute Care Surgery service at the hospital of interest tend to be older, more complex, and require longer stays than those admitted through the emergency department. From information obtained during this research we hope to establish better systems for tracking these patients, allocating resources, and promoting patient safety and satisfaction.


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