Observational studyBMC health services research2020
Potentially avoidable inter-facility transfer from Veterans Health Administration emergency departments: A cohort study.
Observational study in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Telehealth Use and Health Equity for Mental Health and Substance Use Disorder During the COVID-19 Pandemic: A Systematic Review.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024Pooled it
- Barriers to Timely Percutaneous Coronary Intervention (PCI) in Rural vs. Urban Settings: A Health System Approach.Cureus · 2025Article
- Examining contextual differences in suicide by rural-urban designation and military status, 2009-2019: a cross-sectional analysis of the National Violent Death Reporting System.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
- Factors Associated with Acute Telemental Health Consultations in Older Veterans.The western journal of emergency medicine · 2024Article
- Community Emergency Care Use by Veterans in an Era of Expanding Choice.JAMA network open · 2024Observational
- The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Continuing the transformation: charting the path for the future delivery of Veteran emergency care.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Research and policy recommendations from the SOTA XVI: State of the Art Conference on VA Emergency Medicine.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Telemental health in emergency care settings: A qualitative analysis of considerations for sustainability and spread.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Development and Pilot of a Process for Regularly Sharing Summary Patient Safety Data.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2023Article
- Potentially avoidable interfacility transfers following reduced emergency department volumes due to COVID-19 "Safer-at-Home" orders.The American journal of emergency medicine · 2022Article
- Implementation of Telehealth for Psychiatric Care in VA Emergency Departments and Urgent Care Clinics.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2022Article
- Association between prehospital shock index and mortality among patients with COVID-19 disease.The American journal of emergency medicine · 2022Article
- Transfer boarding delays care more in low-volume rural emergency departments: A cohort study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- Association of insurance status with potentially avoidable transfers to an academic emergency department: A retrospective observational study.Journal of the American College of Emergency Physicians open · 2021Article
- Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.The American journal of emergency medicine · 2021Article
- Hypoxemia Index Associated with Prehospital Intubation in COVID-19 Patients.Journal of clinical medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundInter-facility transfer is an important strategy for improving access to specialized health services, but transfers are complicated by over-triage, under-triage, travel burdens, and costs. The purpose of this study is to describe ED-based inter-facility transfer practices within the Veterans Health Administration (VHA) and to estimate the proportion of potentially avoidable transfers.
methodsThis observational cohort study included all patients treated in VHA EDs between 2012 and 2014 who were transferred to another VHA hospital. Potentially avoidable transfers were defined as patients who were either discharged from the receiving ED or admitted to the receiving hospital for ≤1 day without having an invasive procedure performed. We conducted facility- and diagnosis-level analyses to identify subgroups of patients for whom potentially avoidable transfers had increased prevalence.
resultsOf 6,173,189 ED visits during the 3-year study period, 18,852 (0.3%) were transferred from one VHA ED to another VHA facility. Rural residents were transferred three times as often as urban residents (0.6% vs. 0.2%, p < 0.001), and 22.8% of all VHA-to-VHA transfers were potentially avoidable transfers. The 3 disease categories most commonly associated with inter-facility transfer were mental health (34%), cardiac (12%), and digestive diagnoses (9%).
conclusionsVHA inter-facility transfer is commonly performed for mental health and cardiac evaluation, particularly for patients in rural settings. The proportion that are potentially avoidable is small. Future work should focus on improving capabilities to provide specialty evaluation locally for these conditions, possibly using telehealth solutions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.