IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i6p871-d1669498.html
   My bibliography  Save this article

The Impact of a Novel Transfer Process on Patient Bed Days and Length of Stay: A Five-Year Comparative Study at the Mayo Clinic in Rochester and Mankato Quaternary and Tertiary Care Centers

Author

Listed:
  • Anwar Khedr

    (BronxCare Health System, Bronx, NY 10457, USA)

  • Esraa Hassan

    (Mayo Clinic, Rochester, MN 55905, USA)

  • Rida Asim

    (Department of Internal Medicine, Karachi Medical and Dental College, Karachi 74700, Pakistan)

  • Muhammad Khuzzaim Khan

    (Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan)

  • Nikhil Duseja

    (Department of Internal Medicine, Karachi Medical and Dental College, Karachi 74700, Pakistan)

  • Noura Attallah

    (Henry Ford Health System, Jackson, MI 49201, USA)

  • Jennifer Mueller

    (Mayo Clinic, Rochester, MN 55905, USA)

  • Jamie Newman

    (Mayo Clinic, Rochester, MN 55905, USA)

  • Erica Loomis

    (Mayo Clinic, Rochester, MN 55905, USA)

  • Jennifer Bartelt

    (Mayo Clinic, Rochester, MN 55905, USA)

  • Syed Anjum Khan

    (Mayo Clinic, Rochester, MN 55905, USA)

  • Brian Bartlett

    (Mayo Clinic, Rochester, MN 55905, USA)

Abstract

Introduction: This study evaluated the impact of parallel-level patient transfers on bed utilization efficiency within the Mayo Clinic Health System in Southern Minnesota, focusing on optimizing resources across tertiary and critical access hospitals. Methods: A retrospective analysis of 179,066 Emergency Department visits (2018–2022) was conducted, with ~2% involving parallel-level transfers for observation or admission. Machine learning was utilized to identify patients suitable for parallel transfers based on demographics, comorbidities, and clinical factors. A Random Forest model with an AUROC of 0.87 guided transfer decisions. Saved patient days were calculated as the difference between the actual LOS and the benchmark LOS based on Diagnosis-Related Groups (DRGs). Generalized estimating equations analyzed length of stay (LOS) differences, adjusted for confounders, with 95% confidence intervals (CI). Statistical analyses were conducted using SPSS (v.26). Results: The mean patient age was 56 years (SD = 17.2), with 51.4% being female. Saved patient days increased from ~600 to 5200 days over the study period. Transferred patients had a 5.7% longer unadjusted LOS compared to non-transferred patients (95% CI: 2.9–8.6%, p < 0.001). After adjustment for demographics and comorbidities, the LOS difference was not significant (adjusted mean difference: 0.4%, 95% CI: −1.7–2.5%, p = 0.51). Conclusions: Parallel-level transfers increased saved patient days, reflecting enhanced resource utilization. However, the adjusted LOS differences were not significant, highlighting the need for robust transfer protocols and controlled studies to confirm these findings.

Suggested Citation

  • Anwar Khedr & Esraa Hassan & Rida Asim & Muhammad Khuzzaim Khan & Nikhil Duseja & Noura Attallah & Jennifer Mueller & Jamie Newman & Erica Loomis & Jennifer Bartelt & Syed Anjum Khan & Brian Bartlett, 2025. "The Impact of a Novel Transfer Process on Patient Bed Days and Length of Stay: A Five-Year Comparative Study at the Mayo Clinic in Rochester and Mankato Quaternary and Tertiary Care Centers," IJERPH, MDPI, vol. 22(6), pages 1-13, May.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:6:p:871-:d:1669498
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/6/871/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/22/6/871/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. van Wijk, Cecile M. T. Gijsbers & van Vliet, Katja P. & Kolk, Annemarie M., 1996. "Gender perspectives and quality of care: Towards appropriate and adequate health care for women," Social Science & Medicine, Elsevier, vol. 43(5), pages 707-720, September.
    2. Puentes-Markides, Cristina, 1992. "Women and access to health care," Social Science & Medicine, Elsevier, vol. 35(4), pages 619-626, August.
    3. Alexander Maximilian Fassmer & Alexandra Pulst & Guido Schmiemann & Falk Hoffmann, 2020. "Sex-Specific Differences in Hospital Transfers of Nursing Home Residents: Results from the HOspitalizations and eMERgency Department Visits of Nursing Home Residents (HOMERN) Project," IJERPH, MDPI, vol. 17(11), pages 1-11, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Perelman, Julian & Mateus, Céu & Fernandes, Ana, 2010. "Gender equity in treatment for cardiac heart disease in Portugal," Social Science & Medicine, Elsevier, vol. 71(1), pages 25-29, July.
    2. Ioanna G. Gkiza & Stefanos A. Nastis, 2017. "Health and Women’s Role in Agricultural Production Efficiency," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 39(3), pages 428-440.
    3. Spicer, Neil J., 2005. "Sedentarization and children's health: Changing discourses in the northeast Badia of Jordan," Social Science & Medicine, Elsevier, vol. 61(10), pages 2165-2176, November.
    4. Zacharia S. Masanyiwa & Anke Niehof & Catrien J. A. M. Termeer, 2015. "A gendered users′ perspective on decentralized primary health services in rural Tanzania," International Journal of Health Planning and Management, Wiley Blackwell, vol. 30(3), pages 285-306, July.
    5. Anita K Wagner & Amy J Graves & Zhengyu Fan & Saul Walker & Fang Zhang & Dennis Ross-Degnan, 2013. "Need for and Access to Health Care and Medicines: Are There Gender Inequities?," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-10, March.
    6. Alexander Hamilton & John Hudson, 2014. "The Tribes that Bind: Attitudes to the Tribe and Tribal Leader in the Sudan," Department of Economics Working Papers 31/14, University of Bath, Department of Economics.
    7. Bruno Gabriel Salvador Casara & Alice Lucarini & Eric D Knowles & Caterina Suitner, 2024. "Unveiling gender inequality in the US: Testing validity of a state-level measure of gender inequality and its relationship with feminist online collective action on Twitter," PLOS ONE, Public Library of Science, vol. 19(7), pages 1-13, July.
    8. Divya Malhotra, 2017. "Cultural Concordance and Health Accessibility Differentials in Israel: Field Survey in Tel Aviv," Contemporary Review of the Middle East, , vol. 4(4), pages 356-384, December.
    9. Joana Cima & Paulo Guimarães & Álvaro Almeida, 2018. "Explaining the gender gap in waiting times for scheduled surgery in the Portuguese National Health Service," FEP Working Papers 607, Universidade do Porto, Faculdade de Economia do Porto.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:6:p:871-:d:1669498. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.