Tertiary Hospital Transfers For Evaluation And Treatment Of The Infected Hand: A Healthcare Cross-sectional Analysis
Paul R. Clark, MD.
UT Houston, Houston, TX, USA.
PURPOSE:Previous publications regarding hand patient transfers focus primarily on traumatic injuries or in combination with infections; many are single institution experiences. There has not been a large-scale healthcare analysis regarding patients transferred for hand infections; this is the purpose of our investigation.
METHODS:A cross-sectional analysis was performed using the Texas Healthcare Information Collection Database between 2015-2019. Data was queried for CPT and ICD 10 codes associated with infections distal to the elbow. Statistical analyses were performed for several patient demographics and healthcare metrics. Surgeries were categorized based on the ICD-10.
RESULTS:3,581 patients were transferred for hand infections. Patients most common primary insurance (34.7%) was self-pay. 50.5 % of patients had Surgeries. Subcutaneous tissue was the most common operative layer. Most common surgeries were drainage 46.7 % or excision 41.1%. Operative patients' LOS was 7.7 days, versus 14.9 for non-operative (p<0.001). Weekend transfers had decreased average LOS relative to weekday (mean 7.7 ± 9.5 days versus 12.3 ± 15.2 days; p<0.001), but a 94.7% increased odds of operation (OR=1.947 [95% CI, 1.652-2.294]; p<0.001).
CONCLUSION:Many patients are transferred to tertiary centers within Texas for hand infections annually. Roughly 1/3 of transferred hand infection patients were self-pay. Patients managed with operations most frequently had a drainage procedure. Operative patients had a shorter average LOS especially those transferred on a weekend. 
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