Bergeron Catherine, Fleet Richard, Tounkara Fatoumata Korika, Lavallée-Bourget Isabelle, Turgeon-Pelchat Catherine
Chaire de recherche en médecine d'urgence de l'Université Laval, CHAU Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada.
Department of Family Medicine and Emergency Medicine, Université Laval, 1050, Avenue de la Médecine, Québec City, QC, G1V 0A6, Canada.
BMC Res Notes. 2017 Dec 28;10(1):772. doi: 10.1186/s13104-017-3071-1.
Rural emergency departments (EDs) are an important gateway to care for the 20% of Canadians who reside in rural areas. Less than 15% of Canadian rural EDs have access to a computed tomography (CT) scanner. We hypothesized that a significant proportion of inter-facility transfers from rural hospitals without CT scanners are for CT imaging. Our objective was to assess inter-facility transfers for CT imaging in a rural ED without a CT scanner.
We selected a rural ED that offers 24/7 medical care with admission beds but no CT scanner. Descriptive statistics were collected from 2010 to 2015 on total ED visits and inter-facility transfers. Data was accessible through hospital and government databases. Between 2010 and 2014, there were respectively 13,531, 13,524, 13,827, 12,883, and 12,942 ED visits, with an average of 444 inter-facility transfers. An average of 33% (148/444) of inter-facility transfers were to a rural referral centre with a CT scan, with 84% being for CT scan. Inter-facility transfers incur costs and potential delays in patient diagnosis and management, yet current databases could not capture transfer times. Acquiring a CT scan may represent a reasonable opportunity for the selected rural hospital considering the number of required transfers.
农村急诊科是居住在农村地区的20%加拿大人获得医疗服务的重要通道。不到15%的加拿大农村急诊科能够使用计算机断层扫描（CT）扫描仪。我们推测，很大一部分从没有CT扫描仪的农村医院进行的机构间转诊是为了进行CT成像。我们的目的是评估在没有CT扫描仪的农村急诊科进行CT成像的机构间转诊情况。
我们选择了一家提供全天候医疗服务且设有住院床位但没有CT扫描仪的农村急诊科。收集了2010年至2015年期间急诊科总就诊人数和机构间转诊的描述性统计数据。数据可通过医院和政府数据库获取。2010年至2014年期间，急诊科就诊人数分别为13531、13524、13827、12883和12942人次，平均机构间转诊444次。平均33%（148/444）的机构间转诊是转到有CT扫描设备的农村转诊中心，其中84%是为了进行CT扫描。机构间转诊会产生成本，并可能导致患者诊断和治疗的延迟，但目前的数据库无法记录转诊时间。考虑到所需的转诊次数，购置CT扫描仪对选定的农村医院来说可能是一个合理的机会。
