Abstract
Purpose :
Community hospitals face rising challenges in securing ophthalmology specialty coverage in emergency settings, potentially leading to increases in ophthalmology patient transfer requests to academic and tertiary care medical centers. We aim to analyze the trends and nature of ophthalmology transfers to Harborview Medical Center (HMC), an academic tertiary care referral hospital and level 1 trauma center in Seattle, Washington, over a recent six-year period.
Methods :
68 months of transfer center data were collected from January 2018 to August 2023. Data includes the referring facility, reason for transfer, and whether the transfer was accepted. Annual trends in transfer characteristics were assessed using ANOVA with quadratic trend fitting.
Results :
A total of 5766 ophthalmology transfer calls were documented in the 68-month period, with 3396 patients accepted for transfer. Ophthalmology transfers comprised 9.7% of all incoming transfers (33,117) to HMC from 2018-2023. 96% of accepted transfers were from Washington state, with 60.5% of transfers from within 45 miles of HMC. While the Washington state population has increased 7% from 2018-2023, ophthalmology transfer calls at HMC have increased by 45%, from an average of 74 ± 9 per month in 2018 to 108 ± 26 per month in 2023 (ptrend = 0.01), and accepted transfers have increased 23%, from an average of 49 ± 6 per month in 2018 to 60 ± 17 in 2023 (ptrend < 0.001). This trend is primarily driven by an increase in calls from hospitals, which have increased 53%, from an average of 65 ± 8 calls per month in 2018 to 100 ± 23 calls per month in 2023 (ptrend < 0.001). Lack of a specialist at the referring hospital was the reason for transfer in 53% of transferred patients, and the average number of patients transferred for this reason has increased 183%, from 27 ± 6 per month in 2018 to 75 ± 25 per month in 2023 (ptrend < 0.001).
Conclusions :
From 2018-2023, Harborview Medical Center, an academic tertiary care center and level 1 trauma center, experienced an increase in hospital transfer calls and accepted patients for ophthalmic issues. This is predominantly due to lack of ophthalmology specialists in referring hospitals. Further studies could analyze patient characteristics of the transfers as well as trends at other similar hospitals to better understand the shift of emergency ophthalmology care to academic tertiary care centers nationwide.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.