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 |