Factors related to adverse events in referring patients from Khon Kaen Hospital, Khon Kaen Province, for continuing treatment near their homes: a retrospective cohort study

Comprehending the factors linked to adverse events during patient referrals is essential for developing standardized safety protocols. These findings will enhance referral practices and mitigate complications in high-volume referral hospitals. The purpose of this study was to examine the factors associated with adverse events during referrals for continued treatment at community hospitals near patient homes. This retrospective cohort study collected data from a patient medical record database at Khon Kaen Hospital during 2019-2021. The study population consisted of 441 patients evaluated by an attending physician for referral to ongoing treatment at a nearby hospital. The data were analyzed using the generalized linear model to assess the adjusted relative risk (RR) with a 95% confidence interval. After adjusting the variables in the final model, the study showed statistical significance for certain factors relating to the adverse events in referring patients to continuing treatment near home (p<0.05). These factors included intubated patients (adjusted RR:2.07; 95%CI:1.33-2.86), patients with a principal diagnosis of infection (adjusted RR: 1.83; 95% CI: 1.16-2.89), patients with a principal diagnosis of respiratory problems (adjusted RR: 1.57; 95% CI: 1.01-2.44) and patients with a principal diagnosis of cardiovascular disease (adjusted RR: 1.84; 95% CI: 1.22-2.78). Therefore, there should be patient referral procedures that are tailored for patients with each group of diseases, especially in intubated patients with infection, respiratory, or cardiovascular diseases, as they are more likely to experience adverse events during patient referral. These tailored procedures should cover the assessment of patients by a medical specialist in that disease group and clear communication of the patient's information on treatment and symptoms before starting the patient referral process.