Out-of-hospital transfer of trauma patients.

This study examined a large number of demographic, hospital, and medical factors that may influence out-of-hospital transfer for trauma patients. Data from the 1977 and 1978 National Hospital Discharge Survey were used to assemble a case-control data set of injuries (n=4576); cases were defined as transfers out of hospital and controls were discharges to home. Controls were frequency matched to cases based on overall severity, site of the most severe anatomic injury, and age. The analysis estimated the relative risk of transfer associated with different levels of the risk factors by the odds ratio. The analysis was performed twice, once for the full case-control data set and a second time for patients with severe injuries. Of the risk factors examined the only strong, consistent relationships with patient transfer were found for marital status and region of country. Individuals who were not married were at nearly twice the risk of transfer compared with married individuals; likewise patients hospitalized in the western US were twice as likely to be transferred as patients in Southern hospitals. Possible reasons for these results are offered.