[Transportation by ambulance in a rural district in Iceland during the years 1990-1996.]

The Health Centre at Kirkjubaejarklaustur serves a large rural district with a population a little over 600. Agriculture and various services including tourism are the main occupations. Almost 20% of the population are over 65 years of age, which is an unusually high figure compared to the rest of the country. Ambulance transports are one of the health centre's responsibilities. Most of these are surface transports to hospitals, 200-250 kilometres away.

The purpose of this study was to explore and explain the nature of all ambulance transports provided by the Kirkjubaejarklaustur Health Centre from 1990-1996.

A retrospective analysis was performed on all ambulance transports provided by the Kirkjubaejarklaustur Health Centre during the period. The data provided by the Health Centre and by transport personnel was used. Information was relatively easy to get since documentation was done by very few persons. The transports were looked at in terms of prevalence, age, gender, points of departure and destination, diagnosis, time of day, attending person and whether a local person or a tourist was being transported.

Annual ambulance transport prevalence is 50 for every 1000 inhabitants. The prevalence for the whole country is 72, for the city of Reykjavik 90. Tourists account for 27% of transports. Accidents were the reason for transport in almost one third of cases. Males and elderly persons account for a significant number of the transports. This is congruent with other studies. Ambulance transport decreased significantly during the last two years of the study period. The most plausible explanation of this is the opening of a 20 bed nursing home in the district in mid year 1994.

Ambulance transport including the preparation of the sick or injured person is an important part of health care in this region. General practitioners need to be well versed in emergency medicine and ambulance attendants in preparing the patient for transport. Therefore continuing education is an important factor in this discussion. Tourism in the summertime may prompt the need for increased staffing in the health care sector. There is no indication that helicopter transport will replace surface transport in the near future except in special cases as it has been. Good primary health care and regular access to physicians in the nursing home setting decrease the need for ambulance transport. Further studies in the area of ambulance transport especially concerning tourists and the elderly are needed in the Icelandic context. Both groups are on increase and will probably be more in demand of emergency medical services such as ambulance transports.