Faculty Collaboration Database

Informed consent for patient transfers to a Veterans Affairs medical center. J Gen Intern Med 1991;6(3):229-32

Date

05/01/1991

Pubmed ID

2066827

DOI

10.1007/BF02598965

Scopus ID

2-s2.0-0025854319 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

OBJECTIVE: To evaluate whether informed consent was obtained prior to transfers of patients from a community hospital to a Veterans Affairs medical center.

DESIGN: Cross-sectional study.

SETTING: A Department of Veterans Affairs medical center.

PARTICIPANTS: Eighty-six consecutive interhospital-transferred patients. Nearly all were white men, with a median age of 62.5 years. Fifty percent had three or more active medical problems and 17% had been transferred from intensive care units.

MEASUREMENTS AND MAIN RESULTS: The authors defined informed consent as a discussion of benefits, risks, and alternatives to transfer. Following transfer, patients and physicians were interviewed using standardized parallel questionnaires. Physician-patient communication regarding the benefits and risks of transfer was infrequent. Informed consent was reported for none of the transfers by patient interview, compared with 11% of the transfers assessed by physician interview. Risks of transfer were discussed infrequently according to both physicians (17%) and patients (13%). Physicians perceived a risk to the patient in 21% of patient transfers, and in 36% of transfers defined by objective criteria as high-risk. Physicians recalled discussing benefits of transfer more frequently than did patients (80% vs. 42%,t test, p less than 0.001). Physicians also recalled discussing alternatives to transfer more frequently than did patients (61% vs. 18%, t test p less than 0.001).

CONCLUSIONS: Verbal informed consent is obtained infrequently prior to interhospital transfer of patients. Risks of transfer are seldom perceived and discussed with patients.

Author List

Jablonski DF, Mosley GM, Byrd JC, Schwallie D, Nattinger AB

Author

Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Chi-Square Distribution
Cross-Sectional Studies
Disclosure
Female
Hospitals, Community
Hospitals, Veterans
Humans
Informed Consent
Male
Middle Aged
Patient Transfer
Physician's Role
Risk
Risk Assessment
Surveys and Questionnaires
United States