A retrospective observational study examining interhospital transfers from six New Zealand rural hospitals in 2019

ObjectiveThe aim of this study was to identify the percentage of patients that were transferred from rural hospitals and who received an investigation or intervention at an urban hospital that was not readily available at the rural hospital. MethodsA retrospective observational study. DesignPatients were randomly selected and clinical records were reviewed. Patient demographic and clinical information was collected, including any interventions or investigations occurring at the urban referral hospital. These were compared against the resources available at the rural hospitals. SettingSix New Zealand (NZ) rural hospitals were included. ParticipantsPatients that were transferred from a rural hospital to an urban hospital between 1 Jan 2019 and 31 December 2019 were included. Main Outcome MeasuresThe primary outcome measure was the percentage of patients who received an investigation or intervention that was not available at the rural hospital. ResultsThere were 584 patients included. Overall 73% of patients received an intervention or investigation that was not available at the rural hospital. Of the six rural hospitals, there was one outlier, where only 37% of patients transferred from that hospital received an investigation or intervention that was not available rurally. Patients were most commonly referred to general medicine (23%) and general surgery (18%). Of the investigations or interventions performed, 43% received a CT scan and 25% underwent surgery. ConclusionsMost patients that are transferred to urban hospitals receive an intervention or investigation that was not available at the rural hospital.