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  • Thresholds for requesting transfers to tertiary care were influenced by perceptions of the current illness and differences in perceptions of the initial hospital and tertiary care centre

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Qualitative
Thresholds for requesting transfers to tertiary care were influenced by perceptions of the current illness and differences in perceptions of the initial hospital and tertiary care centre

https://doi.org/10.1136/ebn.9.3.93

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    Dy SM, Rubin HR, Lehmann HP. Why do patients and families request transfers to tertiary care? A qualitative study. Soc Sci Med 2005;61:1846–53.OpenUrlCrossRefPubMedWeb of Science

    Q Why do patients or their surrogates request transfers to tertiary care?

    DESIGN

    Qualitative interview study with ethnographic decision modelling.

    SETTING

    A large regional tertiary care centre in Baltimore, Maryland, USA.

    PARTICIPANTS

    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.

    METHODS

    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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    Footnotes

    • For correspondence: Dr S M Dy, Bloomberg School of Public Health and School of Medicine, Johns Hopkins University, Baltimore, MD, USA. sdy{at}jhsph.edu

    • Source of funding: not stated.