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What small rural emergency departments do: A systematic review of observational studies
Author(s) -
Baker Tim,
Dawson Samantha L.
Publication year - 2013
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12046
Subject(s) - observational study , psychological intervention , medicine , medical emergency , emergency department , metropolitan area , systematic review , medline , family medicine , emergency medicine , nursing , pathology , political science , law
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 P ubmed/ M edline and E mbase 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 C anada, six were from A ustralia and four from the U nited S tates. 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.