[Evaluation of visits to an emergency department in rural population]

In an emergency department within a rural population far from a hospital, 1265 patients requested urgent medical care over a 3-year period; they were treated by the duty family physician, who carried out this study. Most patients were residents (insured by Kupat Holim) but a few were inland or foreign tourists. There were 647 males and 618 females, with 13% under the age of 1 year or over the age of 65; age did not affect the number of visits significantly. There were more visits on holidays, Fridays and Saturdays than on other days. There was a slight increase in the proportion of patients referred to hospital during the course of the 3-years, but only a few had to be transferred to hospital by ambulance accompanied by a physician. Most visits were not considered urgent. 32.3% of visits were considered unnecessary in the first year, 19.6% in the second and 21.1% in the third. All visits involving accidents, injuries, poisoning and violence, and almost all involving circulatory system diseases, were considered urgent and appropriate. This is the first attempt of its kind in this country to characterize visits to an emergency room distant from a hospital, and to evaluate their urgency and appropriateness.