Life-threatening emergencies: patterns of demand and response of a regional emergency medical services system

This study focused on the nature and disposition of life-threatening emergencies. The data were drawn from hospital records (1,266 cases) from a 15-county area in the southeastern United States, consisting of a central metropolitan area surrounded by predominantly rural counties. The most important finding was that rural emergency departments transferred 7.4 percent of their patients. This proportion seems particularly low in light of emergency department categorizations and physician training data for the area. It may suggest underutilization of the region's resources by rural emergency care providers. Over a third of the life-threatening emergencies studied were cardiovascular, 17.9 percent medical, 13.3 percent trauma, and 9.7 percent neurological. The emergency department mortality rate for rural hospitals (11.5 percent) was nearly twice that of nonrural hospitals (6.8 percent).