Objectives: To assess necessary treatment and degree of urgency
for patients admitted to emergency rooms, and potential health consequences of
transfer to nearest alternative hospital.
Methods: During 1 month, we included all 1,300 emergently admitted
patients in all seven general hospitals in a Norwegian county with a
population of 236,921 inhabitants. The number of patients in need of surgical
and/or intensive medical treatment, the urgency of the necessary
treatment, and the risk to each patient of adverse permanent health
consequences of further transport to nearest alternative hospital were
assessed by a multidisciplinary expert panel.
Results: Ninety-four patients (7.2% of 1300 patients) were
considered in need of either surgical (n = 22) or intensive medical treatment
(n = 70) or both (n = 2) within 8 hours of arrival in hospital. Medical
treatment had the greatest urgency, while surgery most often could be
postponed. In cases where the patients were initially to be given only
stabilizing treatment and then transported (assisted by qualified personnel)
to another hospital, the panel estimated the risk of losing health benefit to
be high for 14 patients. In six of these cases the risk was linked to delay of
Conclusions: Fewer than 10% of the patients who are admitted as
emergency cases to general hospitals in Norway need surgical or intensive
medical treatment within 8 hours of their arrival. The medical consequences of
transport of patients to the nearest alternative hospital are generally small
and can often be further reduced by simple means.