Evidence map›Paper›PMID 39367748›Full record

ArticleJournal of hospital medicine2025

Interhospital transfer among US veterans admitted to community and veterans affairs hospitals for acute myocardial infarction and ischemic stroke before and during the COVID-19 pandemic.

Mary S Vaughan-Sarrazin, Kelly Richardson Miell, Brice F Beck, Bradley Mecham, George Bailey, Shylo Wardyn, Nicholas Mohr, Michael Ohl

Abstract read
In one paragraph

Article in Journal of hospital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mary S Vaughan-SarrazinVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.ORCID http://orcid.org/0000-0001-8717-1061
Kelly Richardson MiellVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Brice F BeckVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Bradley MechamVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.
George BaileyVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Shylo WardynVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Nicholas MohrVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Michael OhlVeterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa, USA.

Funding

Department of VA, Veterans Health Administration Office of Rural HealthVA Health Services Research and Development service
6 · The paper itself

Abstract

backgroundVeterans Health Administration (VHA) enrollees may use community hospitals for inpatient care and sometimes require transfer to larger community or VHA hospitals. Little is known about interhospital transfer patterns among veterans using community and VHA hospitals or how coronavirus disease 2019 (COVID-19) case surges affected transfer.

methodsRetrospective cohort study among veterans age 65+ admitted to community and VHA hospitals for acute myocardial infarction (AMI) or acute ischemic stroke (AIS) during 2018-2021. We examined associations between COVID-19 case density in regional hospital referral networks and the likelihood of transfer.

resultsA total of 8373 (23.6%) veterans with AMI and 4630 (13.1%) with AIS were transferred in the prepandemic period. Transfer was especially common for rural veterans (36% with AMI, 20% with AIS). Most transfers (88%) were between community hospitals and 6% from community to VHA. Among AMI patients, transfer was less likely among patients age >90 (relative to age 65-69), those with non-White race/ethnicity, and females. Transfer was more common among patients initially seen in rural hospitals (AMI, odds ratio [OR] = 2.73, 95% confidence interval [CI], 2.90-3.74; AIS, OR = 2.43; 95% CI, 2.24-2.65). During 2020-2021, transfer among AMI patients was less likely during COVID-19 case density surges affecting the admitting hospital's referral network (OR = 0.86; 95% CI, 0.78-0.96 for highest compared with lowest quartile of COVID-19 cases).

conclusionInterhospital transfer was common for veterans with AMI and AIS, especially among rural veterans. Few transfers were to VHA hospitals. COVID-19 case surges were associated with decreased transfer for veterans with AMI, potentially limiting access to needed care.

Indexed as

COVID-19Hospitals, CommunityHospitals, VeteransIschemic StrokeMyocardial InfarctionPatient TransferVeteransAgedAged, 80 and overFemaleHumansMaleRetrospective StudiesSARS-CoV-2United StatesUnited States Department of Veterans Affairs

Identifiers

PMID39367748
PMCPMC11797533

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.