Affiliation:
1. Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA Los Angeles California USA
2. VA Greater Los Angeles Healthcare System Los Angeles California USA
3. Mass General Brigham Boston Massachusetts USA
4. Division of General Internal Medicine and Primary Care Brigham and Women's Hospital Boston Massachusetts USA
5. Harvard Medical School Boston Massachusetts USA
Abstract
AbstractThe presence of racial and ethnic disparities in interhospital transfer (IHT) within integrated healthcare systems has not been fully explored. We matched Black and Latinx patients admitted to community hospitals in our integrated healthcare system between June 2015 and December 2019 to White patients by origin hospital, age, time of year, and disease severity. We performed conditional logistic regression models to determine if race or ethnicity was associated with IHT in one of the tertiary academic medical centers in the system, adjusting for covariates. The sample contained 107,895 admissions (82.6% White, 7.8% Black, and 9.6% Latinx). Transfer rates were 2.2% versus 2.2% after the Black/White match and 1.8% versus 1.8% after the Latinx/White match. After adjusting for covariates, there was no association between race or ethnicity and IHT (Black vs. White odds ratio [OR]: 0.87, 95% confidence interval [CI]: 0.72–1.07; Latinx vs. White OR: 1.05, 95% CI: 0.79–1.40). This may be due to reduced barriers to transfer with an integrated healthcare system.