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Journal Article

Citation

Baker T, Dawson SL. Aust. J. Rural Health 2013; 21(5): 254-261.

Affiliation

Centre for Rural Emergency Medicine, Deakin University, Warrnambool, Victoria, Australia.

Copyright

(Copyright © 2013, Association for Australian Rural Nurses; National Rural Health Alliance, Publisher John Wiley and Sons)

DOI

10.1111/ajr.12046

PMID

24118147

Abstract

OBJECTIVE: Small rural emergency facilities are an important part of emergency care in many countries. We performed a systematic review of observational studies to determine what is known about the patients these small rural emergency facilities treat, what types of interventions they undertake and how well they perform. METHODS: Pubmed/Medline and Embase databases were systematically reviewed between 1980 and the present. Studies were included if they described hospital-affiliated emergency care facilities which were open 24-hours every day, and described themselves as rural, non-urban or non-metropolitan. Studies were excluded if facilities saw more than 15 000 patients annually. Study quality was assessed using 12 previously described indicators. Key activity and performance data were reported for individual studies but not numerically combined between studies. RESULTS: The search strategy found 19 studies that included quantitative data on activity and performance. Nine studies were from Canada, six were from Australia and four from the United States. The settings and scales used varied widely. Few studies adhered to methodological recommendations. The most common presentation was for injury or poisoning (30-53%). The number of patients requiring attention within 15 min was small (2.5-2.8%). Nurses treated many patients without physician input. CONCLUSIONS: There is only enough evidence in the literature to make the most basic inferences about what small rural emergency departments do. To allow evidence-based improvement, descriptive studies must employ measures and methods validated in the wider emergency medicine literature, and other research techniques should be considered.


Language: en

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