LAUSR

Introduction: Little is known about how hospitals are connected in the care of patients with acute ischemic stroke (IS). We aimed to describe changes over time in the IS interfacility transfer network in the Northeastern U.S. Methods: We used data from inpatient and outpatient Medicare claims in the Northeast region to identify IS patients transferred between hospitals from 2007 to 2011. Receiving hospitals (RHs) were defined as hospitals with annual IS volume of at least 120 admissions and ≥15% of these admissions received as transfers. Transferring hospitals (THs) were defined as non-RHs that transferred ≥15% of total (ED plus inpatient) IS discharges. A connection between hospitals was defined as ≥5 patients/year transferred between any given TH and RH in the region. We generated a map of hospital connections for each year during the study period using ArcGIS 10.3.1. Results: Among 130,338 IS admissions, we identified 6,898 (5%) patient transfers in the Northeast region from 2007-2011. The number of pa...