Patient transfers to a public hospital.

This is a study of interhospital patient transfers to a medium-sized county sponsored hospital. During the three-month period studied, there were 416 patients who met the study criteria. Thirty-eight (9%) of the patients were transferred because the county hospital offered a higher level of medical care or medical services not available at the presenting facility, while the remaining 378 (91%) were transferred because of their health insurance status. Two hundred and ninety-six patients (71%) had no medical insurance of any kind, 117 (28%) had government sponsored health insurance, and three (1%) had private insurance. Of these transferred patients, 32 (8%) arrived in a medically unstable condition and one patient died shortly after suffering a respiratory arrest en route. It is concluded that interhospital transfer of underinsured or uninsured patients may represent a significant risk to patients.