Casualty encounters at a small rural hospital

To describe the reasons for encounter (RFE) at the casualty department of a small rural hospital and to highlight the value of the hospital to the community, and to health care workers, medical educators, and policy makers.

A small South Australian rural town with a population of about 4500 served by a 50-bed hospital that provides a 24 hour casualty service manned by the local three-person general practice on a fee-for-service basis.

Using an integrated computerised health information management system, data on all the RFE at the casualty department were accumulated over 9 months, coded with ICHPPC-2-Defined, analysed and transferred to a spreadsheet for presentation.

There were sex variations in the various age groups with males presenting more commonly with accidents and injuries. The main reasons for encounter were injuries (35%), respiratory system problems (13%), ear problems (10%), infections (5%), ill-defined problems (5%), supplementary classification (5%).

There is sufficient 'clinical material' for undergraduate and graduate training in the management of trauma and orthopaedic problems but insufficient for obstetric and abdominal surgical emergencies in small rural hospitals. Small rural hospitals must be supported and used effectively by educators and policy-makers to help rural doctors meet the needs of the 30% of the Australian population who do not live on the coastal fringe.