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Emergency patient transfers from rural hospitals: a regional study

Published online by Cambridge University Press:  21 May 2015

James T.B. Rourke  and
MaryAnn Kennard
James T.B. Rourke*
Affiliation:
Department of Family Medicine, University of Western Ontario, London, Ont; Southwestern Ontario Rural Medicine Education, Research and Development Unit, University of Western Ontario
MaryAnn Kennard
Affiliation:
Southwestern Ontario Rural Medicine Education, Research and Development Unit, University of Western Ontario
*
Southwestern Ontario Rural Medicine Education, Research and Development, 53 North St., Goderich ON N7A 2T5; jrourke@julian.uwo.ca

Abstract

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Objective:

To clarify case mix, mode of transport and reasons for interfacility transfer from rural emergency departments (EDs) and to make recommendations for improved emergency health care delivery in rural settings.

Methods:

This was a multi-centre descriptive study, based in 5 rural Ontario EDs. Over a 1-year period, all ED patients who required transfer to another hospital were studied. Data collection forms were completed prospectively by the most responsible nurse involved in the transfer. Main measurements included patient age, gender, place of residence, circumstances and reason for transfer, primary diagnosis, mode of transport and receiving hospital.

Results:

Of 53 796 patients who presented to the 5 participating EDs, 98.4% were managed locally and 836 (1.6%) were transferred to referral centres. Most patients (86%) were transferred because they required treatment beyond the scope of the local hospital. The need for orthopedic care, CT and pediatric care accounted for 23.6%, 14.1% and 8.7% of transfers respectively.

Conclusions:

These data suggest that rural family physicians may benefit from increased orthopedic and pediatric training and support. The study also identified a need for increased specialist availability in our rural setting. The high number of transfers for CT scans suggests that some rural health regions should consider acquiring a “regional” CT scanner. The development of a regional hospital, with a CT scanner and specialist resources, especially a general surgery on-call system, would reduce the need for transfer outside the region.

Keywords

emergency servicehospitalhospitals ruralpatient transfersmall hospitals
Type
Small Urban and Rural Issues Médecine rurale et des petits centre urbains
Information
Canadian Journal of Emergency Medicine , Volume 3 , Issue 4 , October 2001 , pp. 296 - 301
Copyright
Copyright © Canadian Association of Emergency Physicians 2001

References

1.Thompson, JM, Berscheid, R, Butt, P, Dodd, G, Drummond, A, MacLellan, K, et al. Recommendations for the management of rural, remote and isolated emergency health care facilities in Canada [executive summary]. J Emerg Med 1997;15:741–3.Google Scholar
2.Canadian Association of Emergency Physicians (CAEP). Rural Committee. Recommendations for the management of rural, remote and isolated emergency health care facilities in Canada. Ottawa: CAEP; 1997.Google Scholar
3.De Freitas, TL, Spooner, GR, Szafran, O.Admissions and transfers from a rural emergency department. Can Fam Physician 1998;44:789–95.Google Scholar
4.Thompson, JM, Ratcliff, MJ.Use of emergency outpatient services in a small rural hospital. Can Fam Physician 1992;38:2322–31.Google Scholar
5.Sampalis, JS, Denis, R, Frechette, P, Brown, R, Fleiszer, D, Mulder, D.Direct transport to tertiary trauma centers versus transfer from lower level facilities: impact on mortality and morbidity among patients with major trauma. J Trauma 1997;43:288–95.Google Scholar
6.Spear, SF.Life-threatening emergencies: patterns of demand and response of a regional emergency medical services system. Am J Prev Med 1986;2:163–8.Google Scholar
7.Krob, MJ, Cram, AE, Vargish, T, Kassell, NF, Davis, JW, Airola, S.Rural trauma care: a study of trauma care in a rural emergency medical services region. Ann Emerg Med 1984;13:891–5.Google Scholar
8.Rogers, FB, Osler, TM, Shackford, SR, Cohen, M, Camp, L, Lesage, M.Study of the outcome of patients transferred to a level I hospital after stabilization at an outlying hospital in a rural setting. J Trauma Inj Infect Crit Care 1999;46:328–33.Google Scholar
9.Mann, NC, Hedges, JR, Mullins, RJ, Helfand, M, Worrall, W, Zechnich, AD.Rural hospital transfer patterns before and after implementation of a statewide trauma system. OHSU Rural Trauma Research Group. Acad Emerg Med 1997;4:764–71.Google Scholar
10.Bintz, M, Cogbill, TH, Bacon, J.Rural trauma care: role of the general surgeon. J Trauma 1996;28:213–9.Google Scholar
11.Grossman, DC, Hart, LG, Rivara, FP, Maier, RV, Rosenblatt, R.From roadside to bedside: the regionalization of trauma care in a remote rural county. J Trauma 1995;38:14–21.Google Scholar
12.Manual of the international statistical classification of diseases, injuries, and causes of death. Geneva: World Health Organization; 1978.Google Scholar
13.Dodd, GAA, Petterson, I.Interhospital transfers from rural hospitals: suggestions for your jump kit (what you shouldn’t leave home without). Can J Rural Med 1998;3(3):142–5.Google Scholar