Which Factors Predict Transfer to Non-Acute Facility Among Patients With Cancer?

A study presented at the 2019 ASH Annual Meeting determined factors that impact discharge to a different non-acute facility (including nursing home, subacute rehabilitation, and other institutional care) among patients with hematologic malignancies.

Researchers conducted a retrospective cohort analysis of the National Inpatient Sample database to identify adults with hematologic malignancies, including multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, chronic myeloid, and lymphoid leukemias.

The analysis identified 505,230 admissions in 2014, of which 15.5% patients (n=78,390) were transferred at discharge, most commonly following a primary diagnosis at admission of unspecified septicemia. Patients who were transferred tended to be older in age compared with those who were not transferred (mean age, 75.4 years vs. 63.3 years). Transferred patients also had longer mean lengths of stay (9.7 days vs. 6.7 days), were more likely to have a Charlson Comorbidity Index ≥3 (75.1% vs. 55.9%), and were more likely to be Medicare beneficiaries (84.1% vs. 55.8%).

The following factors were associated with higher odds of transfer to a different non-acute facility at discharge:

  • Older age
  • Female gender
  • Presence of comorbidities
  • Longer length of stay
  • Diagnosis of myeloma and chronic leukemias

Meanwhile, the following factors were associated with lower odds of being transferred to a different non-acute facility at discharge:

  • Elective admission
  • Insurance type other than Medicare
  • Diagnosis of acute leukemias
  • Receipt of inpatient chemotherapy 

“A future area of exploration is development of a scoring system using the most clinically relevant and strongly associated factors to predict risk of transfer to a different non-acute facility at discharge,” the researchers concluded “This will allow early decision-making and mobilization of resources by healthcare systems for these patients with complex healthcare needs.” 

Reference

Singh SRK, Malapati S, Kumar R, et al. Predictors of transfer to different facility at discharge in patients admitted with hematologic malignancy: a Nationwide Inpatient Sample (NIS) database analysis. Abstract 2132. Presented at the 2019 ASH Annual Meeting, December 7, 2019; Orlando, Florida.