Trends in Ophthalmic Hospital Transfers and Consultations Across US Academic Centers

Academic medical centers increasingly serve as a safety net for urgent and complex ophthalmic conditions, yet trends in the demand for hospital-based ophthalmic services remain poorly characterized.

To characterize multi-institutional trends in ophthalmology interhospital transfer requests and emergency department (ED) and inpatient ophthalmology consultation requests (hereafter, consultations) from other departments within the same hospital, such as emergency medicine or internal medicine, at multiple academic medical centers in the US.

This retrospective, longitudinal, cohort study involved 14 hospitals affiliated with 10 academic medical centers across multiple geographic regions in the US, representing large urban tertiary referral centers serving diverse catchment populations. Participants were patients for whom ED and inpatient interhospital transfers for ophthalmic care were requested and/or accepted, and patients who received inpatient or ED ophthalmic consultation at participating academic medical centers from 2013 through 2024.

Participating institutions were required to be academic hospitals with resident participation in on-call coverage and to maintain hospital transfer or consultation data from at least 2017 onward, with the earliest beginning in 2013.

Trends in population-adjusted and hospital volume-adjusted rates of ophthalmology interhospital transfer requests and ED and inpatient ophthalmology consultations.

A total of 32 131 ophthalmology transfer requests, 23 560 accepted transfers, and 139 356 ophthalmology consultations (83 581 ED and 44 472 inpatient) were recorded across participating hospitals. Transfer requests increased by an aggregate 0.66 (95% CI, 0.51-0.81) per 100 000 state residents per year and accepted transfers by 0.34 per 100 000 state residents per year (95% CI, 0.17-0.51). Among the 7 institutions with consultation data, consultations increased by an aggregate 3.01 per 100 000 state residents per year (95% CI, 2.33-3.69), comprising 2.06 per 100 000 per year for ED consultations (95% CI, 1.51-2.61) and 1.08 per 100 000 per year for inpatient consultations (95% CI, 0.87-1.30). All aggregate trends were significant (false-discovery rate-adjusted P < .001).

In this cohort study, ophthalmic interhospital transfer requests and inpatient and ED ophthalmology consultations increased substantially across academic medical centers over the study period. These trends suggest growing demand for hospital-based ophthalmic care and increasing strain on ophthalmology hospital coverage, with important implications for workforce sustainability and health system planning.