Differentiating Interhospital Transfer Types: Varied Impacts and Diverging Coordination Strategies

Date
2021-07-12
Journal Title
Journal ISSN
Volume Title
Publisher
Production and Operations Management
Abstract
Interhospital transfer (IHT) is common in care delivery. As a form of care transition, IHT faces coordination challenges and can negatively affect care outcomes. Understanding the underlying reasons and the associated operational challenges of different IHT types can help hospital managers design mitigation mechanisms to improve the IHT care outcomes. We conceptually and empirically differentiate between clinical and non-clinical transfers based on their unique characteristics and compare their respective impacts on care outcomes, including length of stay (LOS), readmission, and mortality. Non-clinical transfers are found to have worse care outcomes than clinical transfers and largely accounts for the inferior care outcomes of IHT compared with direct admissions, perhaps due to inadequate care coordination. Since poor coordination between hospitals is frequently cited as a root cause of care quality problems, we investigate whether two coordination mechanisms, namely hospital system affiliation and transfer routinization, can mitigate the potential negative effects of IHT on care outcomes. Our analyses suggest that the two coordination mechanisms are associated with improved IHT outcomes, and both seem to have stronger effects for non-clinical transfers. Specifically, system affiliation and transfer routinization can reduce LOS and readmission for non-clinical transfers. The results offer valuable insights to hospital managers for improving IHT care outcomes.
Description
This is the peer reviewed version of the following article: Fan, R.L., Zhao, M. and Peng, D.X. (2021), Differentiating Interhospital Transfer Types: Varied Impacts and Diverging Coordination Strategies. Prod Oper Manag, 30: 3657-3678. https://doi.org/10.1111/poms.13455, which has been published in final form at https://doi.org/10.1111/poms.13455. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Keywords
coordination mechanism, destination choice strategy, hospital operations management, interhospital transfer types
Citation
Fan, R.L., Zhao, M. and Peng, D.X. (2021), Differentiating Interhospital Transfer Types: Varied Impacts and Diverging Coordination Strategies. Prod Oper Manag, 30: 3657-3678. https://doi.org/10.1111/poms.13455