ADMISSIONS AND TRANSFERS FROM A RURAL EMERGENCY DEPARTMENT

OBJECTIVE To examine the characteristics of patients transferred from a rural hospital emergency department, to compare them with patients a dmitted on an emergency basis, and to use this information to help pla n physician education. DESIGN Descriptive study using records for the period January 1, 1991, to June 30, 1992. SETTING The emergency depart ment at Bonnyville Health Centre, an acute care rural hospital located 240 km northeast of Edmonton, serving a catchment population of appro ximately 10 000. PARTICIPANTS One thousand fifty-five patients seen in the emergency department who were either transferred to another centr e or admitted to the Bonnyville Health Centre on an emergency basis. M AIN OUTCOME MEASURES For the transferred group, main diagnosis, catego ry of transfer, and reason for transfer. For the admitted group, main diagnosis, length of stay, type of discharge. RESULTS Of the 1055 pati ents ill enough to be either admitted or transferred, 114 (10.8%) were transferred. Those transferred were predominantly men, the elderly, a nd people with orthopedic injuries or neurologic diseases. Those admit ted presented primarily with internal, respiratory, gynecologic, or pe diatric disorders. Reason for transfer was mainly lack of specialized services or equipment at the rural hospital. CONCLUSIONS Patients tran sferred out of the emergency department differed from those admitted i n diagnoses and sex. Most transfers were considered ''mandatory.'' Res ults of this analysis supported incorporating a formal rotation in ort hopedics and adding 4 weeks to the existing emergency medicine rotatio n in our family medicine residency program.