Rural ED transfers due to lack of radiology services
Abstract Purpose Our objectives were to determine the frequency of patient transfers to a tertiary care emergency department (Tertiary ED) due to a lack of radiology services in rural hospital EDs (Rural EDs), and examine the community and patient attributes that are associated with these transfers....
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| Veröffentlicht in: | The American journal of emergency medicine 2015-11, Vol.33 (11), p.1630-1634 |
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| container_title | The American journal of emergency medicine |
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| creator | Lyon, Matthew, MD Sturgis, LaShon, MD, PhD Lendermon, Darren, MD Kuchinski, Ann Marie, PhD Mueller, Taylor, MD Candidate Loeffler, Patrick, MD Candidate Xu, Hongyan, PhD Gibson, Robert, PhD |
| description | Abstract Purpose Our objectives were to determine the frequency of patient transfers to a tertiary care emergency department (Tertiary ED) due to a lack of radiology services in rural hospital EDs (Rural EDs), and examine the community and patient attributes that are associated with these transfers. Methods This was a retrospective chart review of patients transferred to a Tertiary ED from Rural EDs. Transfers excluded from the study included pediatric patients (age < 18 years old) and patients transferred for trauma surgeon evaluation. Only those patients who were transferred for radiology services were included in the final analysis. Results Over a 12-month period, 1445 patients were transferred to the Tertiary ED with 73.8% (n = 1066) of this population being transferred from a Rural ED. Excluding 381 trauma and pediatric patients, 64.3% (n = 685) of patients were transferred from a Rural ED and were included in the study. Of these 685 transfers, 24.5% (n = 168) were determined to be due primarily to a lack of a radiology service. Discussion Lack of radiology services in Rural EDs leads to numerous patient transfers to the Tertiary ED each year. A disproportionate number of these transfer patients are African American. These transfers place additional financial and social burdens on patients and their families. This study discusses these findings and alternative diagnostic options (ie, telemedicine and ultrasound video transfer) to address the lack of radiology services available in Rural EDs. The use of these alternate diagnostic options will likely reduce the number of patient transfers to Tertiary EDs. |
| doi_str_mv | 10.1016/j.ajem.2015.07.050 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1728669923</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0735675715006063</els_id><sourcerecordid>1728669923</sourcerecordid><originalsourceid>FETCH-LOGICAL-c509t-417778bb3a5724818438ed30ef771e09ebc16dc165ec345c7d438b3cab3d2d853</originalsourceid><addsrcrecordid>eNp9kU1r3DAQhkVp6G4-_kAOxdBLL3ZHkmXZUAolXy0EAvk4C1kaFzleK5XswP77yOwmhRwqELo882rmGUJOKRQUaPWtL3SPm4IBFQXIAgR8IGsqOMtrKulHsgbJRV5JIVfkMMYegNJSlJ_IilW8bKSs16S8nYMesovzbAp6jB2GmNkZs8lngzaPme-yoK3zg_-zzSKGZ2cwHpODTg8RT_bvEXm4vLg_-5Vf31z9Pvt5nRsBzZSXVKY_2pZrIVlZ07rkNVoO2ElJERpsDa1sugINL4WRNgEtN7rlltla8CPydZf7FPzfGeOkNi4aHAY9op-jopLVVdU0jCf0yzu093MYU3c7iqcDiWI7ygQfY8BOPQW30WGrKKjFqerV4lQtThVIlZymos_76LndoH0reZWYgO87AJOLZ4dBReNwNGhdQDMp693_83-8KzeDG53RwyNuMf6bQ0WmQN0tW12WSgVABWmyF7vsme8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1728633330</pqid></control><display><type>article</type><title>Rural ED transfers due to lack of radiology services</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Lyon, Matthew, MD ; Sturgis, LaShon, MD, PhD ; Lendermon, Darren, MD ; Kuchinski, Ann Marie, PhD ; Mueller, Taylor, MD Candidate ; Loeffler, Patrick, MD Candidate ; Xu, Hongyan, PhD ; Gibson, Robert, PhD</creator><creatorcontrib>Lyon, Matthew, MD ; Sturgis, LaShon, MD, PhD ; Lendermon, Darren, MD ; Kuchinski, Ann Marie, PhD ; Mueller, Taylor, MD Candidate ; Loeffler, Patrick, MD Candidate ; Xu, Hongyan, PhD ; Gibson, Robert, PhD</creatorcontrib><description>Abstract Purpose Our objectives were to determine the frequency of patient transfers to a tertiary care emergency department (Tertiary ED) due to a lack of radiology services in rural hospital EDs (Rural EDs), and examine the community and patient attributes that are associated with these transfers. Methods This was a retrospective chart review of patients transferred to a Tertiary ED from Rural EDs. Transfers excluded from the study included pediatric patients (age < 18 years old) and patients transferred for trauma surgeon evaluation. Only those patients who were transferred for radiology services were included in the final analysis. Results Over a 12-month period, 1445 patients were transferred to the Tertiary ED with 73.8% (n = 1066) of this population being transferred from a Rural ED. Excluding 381 trauma and pediatric patients, 64.3% (n = 685) of patients were transferred from a Rural ED and were included in the study. Of these 685 transfers, 24.5% (n = 168) were determined to be due primarily to a lack of a radiology service. Discussion Lack of radiology services in Rural EDs leads to numerous patient transfers to the Tertiary ED each year. A disproportionate number of these transfer patients are African American. These transfers place additional financial and social burdens on patients and their families. This study discusses these findings and alternative diagnostic options (ie, telemedicine and ultrasound video transfer) to address the lack of radiology services available in Rural EDs. The use of these alternate diagnostic options will likely reduce the number of patient transfers to Tertiary EDs.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2015.07.050</identifier><identifier>PMID: 26349778</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Adolescent ; Adult ; African Americans ; Aged ; Aged, 80 and over ; Census of Population ; Emergency ; Emergency medical care ; Emergency Service, Hospital ; Female ; Health insurance ; Health Services Accessibility - statistics & numerical data ; Healthcare Disparities - statistics & numerical data ; Hospitals, Rural ; Humans ; Male ; Medical imaging ; Medical records ; Middle Aged ; Patient Transfer - statistics & numerical data ; Race ; Radiology ; Radiology Department, Hospital - statistics & numerical data ; Radiology Department, Hospital - supply & distribution ; Retrospective Studies ; Rural areas ; Rural health care ; Rural Health Services - statistics & numerical data ; Rural Health Services - supply & distribution ; Studies ; Telemedicine ; Tertiary Care Centers ; Ultrasonic imaging ; Uninsured people ; Young Adult]]></subject><ispartof>The American journal of emergency medicine, 2015-11, Vol.33 (11), p.1630-1634</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-417778bb3a5724818438ed30ef771e09ebc16dc165ec345c7d438b3cab3d2d853</citedby><cites>FETCH-LOGICAL-c509t-417778bb3a5724818438ed30ef771e09ebc16dc165ec345c7d438b3cab3d2d853</cites><orcidid>0000-0001-7336-2545</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1728633330?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26349778$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lyon, Matthew, MD</creatorcontrib><creatorcontrib>Sturgis, LaShon, MD, PhD</creatorcontrib><creatorcontrib>Lendermon, Darren, MD</creatorcontrib><creatorcontrib>Kuchinski, Ann Marie, PhD</creatorcontrib><creatorcontrib>Mueller, Taylor, MD Candidate</creatorcontrib><creatorcontrib>Loeffler, Patrick, MD Candidate</creatorcontrib><creatorcontrib>Xu, Hongyan, PhD</creatorcontrib><creatorcontrib>Gibson, Robert, PhD</creatorcontrib><title>Rural ED transfers due to lack of radiology services</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Purpose Our objectives were to determine the frequency of patient transfers to a tertiary care emergency department (Tertiary ED) due to a lack of radiology services in rural hospital EDs (Rural EDs), and examine the community and patient attributes that are associated with these transfers. Methods This was a retrospective chart review of patients transferred to a Tertiary ED from Rural EDs. Transfers excluded from the study included pediatric patients (age < 18 years old) and patients transferred for trauma surgeon evaluation. Only those patients who were transferred for radiology services were included in the final analysis. Results Over a 12-month period, 1445 patients were transferred to the Tertiary ED with 73.8% (n = 1066) of this population being transferred from a Rural ED. Excluding 381 trauma and pediatric patients, 64.3% (n = 685) of patients were transferred from a Rural ED and were included in the study. Of these 685 transfers, 24.5% (n = 168) were determined to be due primarily to a lack of a radiology service. Discussion Lack of radiology services in Rural EDs leads to numerous patient transfers to the Tertiary ED each year. A disproportionate number of these transfer patients are African American. These transfers place additional financial and social burdens on patients and their families. This study discusses these findings and alternative diagnostic options (ie, telemedicine and ultrasound video transfer) to address the lack of radiology services available in Rural EDs. The use of these alternate diagnostic options will likely reduce the number of patient transfers to Tertiary EDs.</description><subject>Adolescent</subject><subject>Adult</subject><subject>African Americans</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Census of Population</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Health insurance</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Hospitals, Rural</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Patient Transfer - statistics & numerical data</subject><subject>Race</subject><subject>Radiology</subject><subject>Radiology Department, Hospital - statistics & numerical data</subject><subject>Radiology Department, Hospital - supply & distribution</subject><subject>Retrospective Studies</subject><subject>Rural areas</subject><subject>Rural health care</subject><subject>Rural Health Services - statistics & numerical data</subject><subject>Rural Health Services - supply & distribution</subject><subject>Studies</subject><subject>Telemedicine</subject><subject>Tertiary Care Centers</subject><subject>Ultrasonic imaging</subject><subject>Uninsured people</subject><subject>Young Adult</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU1r3DAQhkVp6G4-_kAOxdBLL3ZHkmXZUAolXy0EAvk4C1kaFzleK5XswP77yOwmhRwqELo882rmGUJOKRQUaPWtL3SPm4IBFQXIAgR8IGsqOMtrKulHsgbJRV5JIVfkMMYegNJSlJ_IilW8bKSs16S8nYMesovzbAp6jB2GmNkZs8lngzaPme-yoK3zg_-zzSKGZ2cwHpODTg8RT_bvEXm4vLg_-5Vf31z9Pvt5nRsBzZSXVKY_2pZrIVlZ07rkNVoO2ElJERpsDa1sugINL4WRNgEtN7rlltla8CPydZf7FPzfGeOkNi4aHAY9op-jopLVVdU0jCf0yzu093MYU3c7iqcDiWI7ygQfY8BOPQW30WGrKKjFqerV4lQtThVIlZymos_76LndoH0reZWYgO87AJOLZ4dBReNwNGhdQDMp693_83-8KzeDG53RwyNuMf6bQ0WmQN0tW12WSgVABWmyF7vsme8</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Lyon, Matthew, MD</creator><creator>Sturgis, LaShon, MD, PhD</creator><creator>Lendermon, Darren, MD</creator><creator>Kuchinski, Ann Marie, PhD</creator><creator>Mueller, Taylor, MD Candidate</creator><creator>Loeffler, Patrick, MD Candidate</creator><creator>Xu, Hongyan, PhD</creator><creator>Gibson, Robert, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7336-2545</orcidid></search><sort><creationdate>20151101</creationdate><title>Rural ED transfers due to lack of radiology services</title><author>Lyon, Matthew, MD ; Sturgis, LaShon, MD, PhD ; Lendermon, Darren, MD ; Kuchinski, Ann Marie, PhD ; Mueller, Taylor, MD Candidate ; Loeffler, Patrick, MD Candidate ; Xu, Hongyan, PhD ; Gibson, Robert, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-417778bb3a5724818438ed30ef771e09ebc16dc165ec345c7d438b3cab3d2d853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>African Americans</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Census of Population</topic><topic>Emergency</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Health insurance</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Hospitals, Rural</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Patient Transfer - statistics & numerical data</topic><topic>Race</topic><topic>Radiology</topic><topic>Radiology Department, Hospital - statistics & numerical data</topic><topic>Radiology Department, Hospital - supply & distribution</topic><topic>Retrospective Studies</topic><topic>Rural areas</topic><topic>Rural health care</topic><topic>Rural Health Services - statistics & numerical data</topic><topic>Rural Health Services - supply & distribution</topic><topic>Studies</topic><topic>Telemedicine</topic><topic>Tertiary Care Centers</topic><topic>Ultrasonic imaging</topic><topic>Uninsured people</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lyon, Matthew, MD</creatorcontrib><creatorcontrib>Sturgis, LaShon, MD, PhD</creatorcontrib><creatorcontrib>Lendermon, Darren, MD</creatorcontrib><creatorcontrib>Kuchinski, Ann Marie, PhD</creatorcontrib><creatorcontrib>Mueller, Taylor, MD Candidate</creatorcontrib><creatorcontrib>Loeffler, Patrick, MD Candidate</creatorcontrib><creatorcontrib>Xu, Hongyan, PhD</creatorcontrib><creatorcontrib>Gibson, Robert, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lyon, Matthew, MD</au><au>Sturgis, LaShon, MD, PhD</au><au>Lendermon, Darren, MD</au><au>Kuchinski, Ann Marie, PhD</au><au>Mueller, Taylor, MD Candidate</au><au>Loeffler, Patrick, MD Candidate</au><au>Xu, Hongyan, PhD</au><au>Gibson, Robert, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rural ED transfers due to lack of radiology services</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>33</volume><issue>11</issue><spage>1630</spage><epage>1634</epage><pages>1630-1634</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Abstract Purpose Our objectives were to determine the frequency of patient transfers to a tertiary care emergency department (Tertiary ED) due to a lack of radiology services in rural hospital EDs (Rural EDs), and examine the community and patient attributes that are associated with these transfers. Methods This was a retrospective chart review of patients transferred to a Tertiary ED from Rural EDs. Transfers excluded from the study included pediatric patients (age < 18 years old) and patients transferred for trauma surgeon evaluation. Only those patients who were transferred for radiology services were included in the final analysis. Results Over a 12-month period, 1445 patients were transferred to the Tertiary ED with 73.8% (n = 1066) of this population being transferred from a Rural ED. Excluding 381 trauma and pediatric patients, 64.3% (n = 685) of patients were transferred from a Rural ED and were included in the study. Of these 685 transfers, 24.5% (n = 168) were determined to be due primarily to a lack of a radiology service. Discussion Lack of radiology services in Rural EDs leads to numerous patient transfers to the Tertiary ED each year. A disproportionate number of these transfer patients are African American. These transfers place additional financial and social burdens on patients and their families. This study discusses these findings and alternative diagnostic options (ie, telemedicine and ultrasound video transfer) to address the lack of radiology services available in Rural EDs. The use of these alternate diagnostic options will likely reduce the number of patient transfers to Tertiary EDs.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26349778</pmid><doi>10.1016/j.ajem.2015.07.050</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-7336-2545</orcidid></addata></record> |
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| subjects | Adolescent Adult African Americans Aged Aged, 80 and over Census of Population Emergency Emergency medical care Emergency Service, Hospital Female Health insurance Health Services Accessibility - statistics & numerical data Healthcare Disparities - statistics & numerical data Hospitals, Rural Humans Male Medical imaging Medical records Middle Aged Patient Transfer - statistics & numerical data Race Radiology Radiology Department, Hospital - statistics & numerical data Radiology Department, Hospital - supply & distribution Retrospective Studies Rural areas Rural health care Rural Health Services - statistics & numerical data Rural Health Services - supply & distribution Studies Telemedicine Tertiary Care Centers Ultrasonic imaging Uninsured people Young Adult |
| title | Rural ED transfers due to lack of radiology services |
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