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Qualitative interview study with ethnographic decision modelling.
A large regional tertiary care centre in Baltimore, Maryland, USA.
Purposeful sample of 32 patients 37–92 years of age (mean age 64 y, 53% women, 87% white) (or their surrogate decision makers) who were transferred to tertiary care. Exclusion criteria were patients transferred as part of a regionalised care system, including psychiatry, trauma, and neonatal intensive care patients; and patients transferred for insurance purposes.
Semistructured interviews were conducted during the patients’ hospital stay at the accepting hospital within 2 weeks of transfer. Questions addressed patients’ roles in decision making, perceptions of the decision making process, reasons for transfer, and factors influencing the decision. Data collection and analysis used …
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