Background: Accessibility to tertiary intensive care resources differs amon
g hospitals within a rural region. Determining whether accessibility is ass
ociated with outcome is important for understanding the role of regionaliza
tion when providing critical care to a rural population.
Methods: In a prospective design, we identified and recorded the mortality
ratio, percentage of unanticipated deaths, length of stay in the intensive
care unit (ICU), and survival time of 147 patients transferred directly fro
m other hospitals and 178 transferred from the wards within a rural tertiar
y-care hospital.
Results: The two groups did not differ significantly in the characteristics
measured. Differences in access to tertiary critical care in this rural re
gion did not affect survival or length of stay after admission to this tert
iary ICU. The odds ratio (1.14; 95% confidence interval 0.72-1.83) for mort
ality associated with transfer from a rural community hospital was not stat
istically significant.
Conclusions: Patients at community hospitals in this area who develop need
for tertiary critical care are just as likely to survive as patients who de
velop ICU needs on the wards of this rural tertiary-care hospital, despite
different accessibility to tertiary intensive-care services.