Emergency patient transfers from rural hospitals: a regional study

James T.B. Rourke, MaryAnn Kennard
2001 CJEM: Canadian Journal of Emergency Medical Care  
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
more » ... . 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.
doi:10.1017/s1481803500005807 fatcat:qwwipjerl5hwbhzf3vn36p7iqm