Modifying Interhospital Hepatopancreatobiliary Transfers Based on Predictive Analytics: Moving from a Center of Excellence to a Health-Care System of Excellence.
Publication/Presentation Date
9-1-2019
Abstract
Regionalization of complex surgical care has increased interhospital transfers to quaternary centers within large health-care systems. Risk-based patient selection is imperative to improve resource allocation without compromising care. This study aimed to develop predictive models for identifying low-risk patients for transfer to a fully integrated satellite hepatopancreatobiliary (HPB) service in the northeast region of the health-care system. HPB transfers to the quaternary center over 15 months from hospitals in proximity to the satellite HPB center. A predictive tool was developed based on simple pretransfer variables and outcomes for 30-day major complications (Clavien grade ≥ 3), readmission, and mortality. Thresholds for "low risk" were set at different SDs below mean for each model. Predictive models were developed from 51 eligible northeast region patient transfers for major complications (Brier score 0.1948, receiver operator characteristic (ROC) 0.7123,
Volume
85
Issue
9
First Page
1033
Last Page
1039
ISSN
1555-9823
Published In/Presented At
Pickens, R. C., Bloomer, A. K., Sulzer, J. K., Murphy, K., Lyman, W. B., Iannitti, D. A., Martinie, J. B., Baker, E. H., Ocuin, L. M., Vrochides, D., & Matthews, B. D. (2019). Modifying Interhospital Hepatopancreatobiliary Transfers Based on Predictive Analytics: Moving from a Center of Excellence to a Health-Care System of Excellence. The American surgeon, 85(9), 1033–1039.
Disciplines
Medicine and Health Sciences
PubMedID
31638520
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article