Andrew L. Rosenberg, MD; Timothy P. Hofer, MD; Cathy Strachan , MSRN; Charles M. Watts, MD; Rodney A. Hayward, MD
Rosenberg AL, Hofer TP, Strachan C, Watts CM, Hayward RA. Accepting Critically Ill Transfer Patients: Adverse Effect on a Referral Center's Outcome and Benchmark Measures. Ann Intern Med. 2003;138:882-890. doi: 10.7326/0003-4819-138-11-200306030-00009
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Published: Ann Intern Med. 2003;138(11):882-890.
Benchmarking compares performance of providers or systems with a standard. Are such comparisons fair, even if they are adjusted for varying case mix and severity of illness of patients?
This prospective study showed that patients who were transferred to an intensive care unit from other hospitals had worse outcomes than those who were directly admitted. In modeling analyses, benchmarking adjusted with sophisticated case-mix and severity-of-illness information, but not admission source, penalized units with a 25% transfer rate (versus a 0% rate) by 14 “excess deaths” per 1000 admissions.
Benchmarking of intensive care unit performance should account for transfer patients.
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