• Julie Considine, Maryann Street, Mari Botti, Bev O'Connell, Bridie Kent, and Trisha Dunning.
• Eastern Health, Deakin University Nursing & Midwifery Research Centre, School of Nursing and Midwifery, Deakin University, Centre for Quality and Patient Safety Research, 221 Burwood Hwy, Burwood, Vic. 3125, Australia. Email.
• Aust Health Rev. 2015 Sep 1; 39 (4): 387-394.

ObjectiveThe aim of the present study was to examine the timing and outcomes of patients requiring an unplanned transfer from subacute to acute care.MethodsSubacute care in-patients requiring unplanned transfer to an acute care facility within four Victorian health services from 1 January to 31 December 2010 were included in the study. Data were collected using retrospective audit. The primary outcome was transfer within 24 h of subacute care admission.ResultsIn all, 431 patients (median age 81 years) had unplanned transfers; of these, 37.8% had a limitation of medical treatment (LOMT) order. The median subacute care length of stay was 43 h: 29.0% of patients were transferred within 24 h and 83.5% were transferred within 72 h of subacute care admission. Predictors of transfer within 24 h were comorbidity weighting (odds ratio (OR) 1.1, P = 0.02) and LOMT order (OR 2.1, P < 0.01). Hospital admission occurred in 87.2% of patients and 15.4% died in hospital. Predictors of in-hospital mortality were comorbidity weighting (OR 1.2, P < 0.01) and the number of physiological abnormalities in the 24 h preceding transfer (OR 1.3, P < 0.01).ConclusionsThere is a high rate of unplanned transfers to acute care within 24h of admission to subacute care. Unplanned transfers are associated with high hospital admission and in-hospital mortality rates.

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