New! A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks

During COVID surges, many hospitals with capacity refused to accept transfer patients because of patients’ uninsured status and complexities associated with interhospital transfer systems, leading to overcrowding at safety-net hospitals.

Charleen Hsuan and colleagues from Penn State University and researchers from the Icahn School of Medicine at Mount Sinai propose the hospital transfer network equity-quality model (NET-EQUITY) — a conceptual framework for understanding emergency department transfers — to foster an equitable population-based system for emergency care. The NET-EQUITY framework explores emergency department networks, spotlights the factors that contribute to inequitable transfer networks, and offers policy responses.

The structure of hospital transfer networks influences patient outcomes, as defined by the Institute of Medicine, which includes equity. The structure of hospital transfer networks is shaped by internal and external factors. The four main external factors are the regulatory, economic environment, provider, and sociocultural and physical/built environment. These environments all implicate issues of equity that are important to understand to foster an equitable population-based system of emergency care. The framework highlights external and internal factors that determine the structure of hospital transfer networks, including structural racism and inequity.

The NET-EQUITY framework provides a patient-centered, equity-focused framework for understanding the health of populations and how the structure of hospital transfer networks can influence the quality of care that patients receive.

Read the article here.