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Comparison of access to services in rural emergency departments in Quebec and British Columbia

Published online by Cambridge University Press:  04 March 2015

Richard Fleet ,
Louis-David Audette ,
Jérémie Marcoux ,
Julie Villa ,
Patrick Archambault  and
Julien Poitras
Richard Fleet*
Affiliation:
Department of Family and Emergency Medicine, Université Laval, Quebec City, QC Research Chair in Emergency Medicine, Université Laval - Hôtel-Dieu de Lévis, Lévis City, QC
Louis-David Audette
Affiliation:
Department of Family and Emergency Medicine, Université Laval, Quebec City, QC
Jérémie Marcoux
Affiliation:
Research Chair in Emergency Medicine, Université Laval - Hôtel-Dieu de Lévis, Lévis City, QC
Julie Villa
Affiliation:
Research Chair in Emergency Medicine, Université Laval - Hôtel-Dieu de Lévis, Lévis City, QC
Patrick Archambault
Affiliation:
Department of Family and Emergency Medicine, Université Laval, Quebec City, QC Research Chair in Emergency Medicine, Université Laval - Hôtel-Dieu de Lévis, Lévis City, QC
Julien Poitras
Affiliation:
Department of Family and Emergency Medicine, Université Laval, Quebec City, QC Research Chair in Emergency Medicine, Université Laval - Hôtel-Dieu de Lévis, Lévis City, QC
*
Correspondence to: Richard Fleet, Research Centre, Hôtel-Dieu de Lévis, 143 Wolfe Street, Lévis, QC G6V 3Z1, [email protected].

Abstract

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Introduction:

Although emergency departments (EDs) in Canada’s rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged.

Objective:

The objective of this project was to compare access to support services in rural EDs between British Columbia and Quebec.

Methods:

Rural EDs were identified through the Canadian Healthcare Association’s Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities (using the rural and small town definition from Statistics Canada). Data were collected from ministries of health, local health authorities, and ED statistics. A telephone interview was administered to collect denominative user data statistics and determine the status of services.

Results:

British Columbia has more rural EDs (n 5 34) than Quebec (n 5 26). EDs in Quebec have higher volumes (19,310 versus 7,793 annual visits). With respect to support services, 81% of Quebec rural EDs have a 24/7 on-call general surgeon compared to 12% for British Columbia. Nearly 75% of Quebec rural EDs have 24/7 access to computed tomography versus only 3% for British Columbia. Rural EDs in Quebec are also supported by a greater proportion of intensive care units (88% versus 15%); however, British Columbia appears to have more medevac aircraft/helicopters than Quebec.

Conclusions:

The results suggest that major differences exist in access to support services in rural EDs in British Columbia and Quebec. A nationwide study is justified to address this issue of variability in rural and remote health service delivery and its impact on interfacility transfers and patient outcomes.

Keywords

computed tomographyemergency departmenthealth servicesrural critical carerural emergency medicinerural general surgery
Type
Original Research • Recherche Originale
Information
Canadian Journal of Emergency Medicine , Volume 16 , Issue 6 , November 2014 , pp. 437 - 448
Copyright
Copyright © Copyright © Canadian Association of Emergency Physicians 2014

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