An Analysis of External Referrals from an Emergency Room

Aim: This study aimed to determine the characteristics and outcomes of patients who were referred from a university hospital emergency room (ER) to other facilities. Material and Methods: This study investigates the characteristics and outcomes of adult patients who were admitted to Hospital Emergency Room (HER) from January 1, 2011 to December 31, 2012 and were referred to another facility for a variety of reasons. Results: Of the 164,810 patients who visited HER in these two years, 429 (0.26%) who met the inclusion criteria were included in the study. The most common reason for referrals was the lack of available intensive care unit beds (51%). The most common medical problem was respiratory system disease (49%). The patients’ mean length of stay in HER before referral was 39 hours (1-360 hours). Most of the referrals were done by ambulance (n=368, 86%). No cardiopulmonary arrests occurred during the transfers, and no cardiopulmonary resuscitation (CPR) was performed. Of the patients, 26% died in the facilities to which they were referred. Only 2.6% of these deaths occurred in the first 24 hours after the transfer. Conclusion: This study found that the rate of referrals from the level-3 emergency room was low, that the most common medical reason for referrals was respiratory diseases, and that the most common reason for referrals was the lack of available intensive care beds. Most of the deaths of patients in the facilities to which they were referred occurred more than 24 hours after their transfers.