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Table 1 Patient and facility characteristics by transfer type

From: The association between clinical integration of care and transfer of veterans with acute coronary syndromes from primary care VHA hospitals

Variable

Overall for study sample N = 755

Not transferred N = 436

Transferred to tertiary VHA hospital N = 237

Transferred to tertiary private hospital N = 82

p-value*

Patient age 65 and over

58.0%

63.1%

52.3%

48.8%

0.005

Prior medical history

Chronic obstructive pulmonary disease

37.1%

40.6%

31.9%

33.7%

0.067

Bleeding disorder

3.6%

2.1%

5.5%

6.2%

0.035

Smoker

31.6%

26.8%

41.8%

27.2%

<0.001

Prior percutaneous coronary intervention

15.2%

11.7%

21.5%

15.8%

0.003

Chronic heart failure

23.0%

28.9%

13.1%

18.8%

<0.001

Course of index hospital admission

ST segment elevation on EKG

17.8%

12.8%

19.0%

39.0%

<0.001

Cardiac enzymes abnormal on presentation

52.5%

52.0%

46.4%

71.3%

<0.001

Do not resuscitate during hospitalization

5.3%

6.7%

2.1%

5.2%

0.039

In-hospital event**

47.3%

37.8%

62.9%

52.4%

<0.001

Distance, market and integration variables

Distance from patient home zip code centroid to hospital >100 miles

18.1%

15.6%

21.1%

22.0%

0.128

Distance from primary VHA to tertiary VHA hospital in miles

281

270

285

326

0.045

Degree of market competition (1 = not competitive; 3 = highly competitive)

1.74

1.82

1.57

1.79

<0.001

VHA cardiologist on site

30.6%

29.8%

36.3%

19.5%

0.015

Tertiary VHA hospital has referral coordinator

54.7%

56.4%

60.8%

30.5%

<0.001

Primary VHA hospital has referral coordinator

33.0%

28.9%

43.9%

24.4%

<0.001

  1. * p-value obtained from ANOVA testing difference between means for patients not transferred, transferred to VHA tertiary hospital, or transferred to non-VHA tertiary hospital for continuous variables, chi-square test of inference for categorical variables
  2. ** Presence of at least one of the following adverse events during admission: angina persisting more than 24 hours after admission; a hypotensive episode; an episode of heart failure; cardiac arrest; or positive stress test during admission