• R Hotvedt, J Thoner, A W Wilskow, and O H Førde.
• University of Tromsø.
• Int J Technol Assess Health Care. 1999 Jan 1;15(4):699-708.

ObjectivesTo assess necessary treatment and degree of urgency for patients admitted to emergency rooms, and potential health consequences of transfer to nearest alternative hospital.MethodsDuring 1 month, we included all 1,300 emergently admitted patients in all seven general hospitals in a Norwegian county with a population of 236,921 inhabitants. The number of patients in need of surgical and/or intensive medical treatment, the urgency of the necessary treatment, and the risk to each patient of adverse permanent health consequences of further transport to nearest alternative hospital were assessed by a multidisciplinary expert panel.ResultsNinety-four patients (7.2% of 1300 patients) were considered in need of either surgical (n = 22) or intensive medical treatment (n = 70) or both (n = 2) within 8 hours of arrival in hospital. Medical treatment had the greatest urgency, while surgery most often could be postponed. In cases where the patients were initially to be given only stabilizing treatment and then transported (assisted by qualified personnel) to another hospital, the panel estimated the risk of losing health benefit to be high for 14 patients. In six of these cases the risk was linked to delay of thrombolytic treatment.ConclusionsFewer than 10% of the patients who are admitted as emergency cases to general hospitals in Norway need surgical or intensive medical treatment within 8 hours of their arrival. The medical consequences of transport of patients to the nearest alternative hospital are generally small and can often be further reduced by simple means.

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