Summary of findings for clinical outcomes
| Publication | Country | Context | Primary findings |
|---|---|---|---|
| Ang et al., 2020 (67) | Australia | Assessment of emergency vascular procedures completed at a rural Australian hospital | 16 patients were unable to be transferred and received emergency vascular procedures; 69% survived with limb salvage |
| Ball et al., 2009 (6) | Canada | Assessment of outcomes of level III trauma centres in Alberta, Canada | Patients who arrived from a level III trauma centre more often had a surgical assessment, 13% required laparotomy alone, and 87% required assessment from other surgical specialists These patients were less likely to arrive unstable compared with level IV centres Rural surgeons were appropriately treating and transferring trauma patients |
| Chaudhary et al., 2017 (31) | United States | Comparison of outcomes in emergency general surgery and trauma between rural and urban centres | Rural patients had higher odds of mortality, were less likely to have major complications, and remained in hospital an average of 0.5 days longer at a cost of $98/d more; the authors concluded that despite statistical significance, they were not clinically significant |
| Gadzinski et al., 2013 (42) | United States | Comparison of postoperative outcomes among surgical patients treated at a critical access hospital compared with other hospitals | Among general surgery patients, there were no statistically significant increased adverse postoperative outcomes among patients treated in critical access hospitals; patients on average were discharged earlier, but their care did cost 9.9%–30.1% more |
| Galandiuk et al., 2006 (78) | United States | Comparison of quality indicators between rural and urban surgeons | Higher volume rural colorectal surgeons have comparable outcomes compared with urban surgeons in cases of colectomy Rural surgeons had similar outcomes compared with urban surgeons when assessing cholecystectomy and endoscopy |
| Luck et al., 2015 (11) | Australia | Assessment of emergency neurosurgical procedures completed in rural Australia | 161 patients required emergency neurosurgical procedures in a rural setting with general surgery Poor outcomes were attributed to distance of patient transfer and the remote location of trauma; outcomes reviewed as acceptable based on those factors |
| Natafgi et al., 2017 (56) | United States | Comparison of adverse events surgical patients in critical access hospitals compared with larger centres | Surgical patients at critical access hospitals had similar rates of reported adverse events compared with larger centres |
| Pandit et al., 2016 (79) | United states | Assessment of rural v. urban surgical management of ulcerative colitis | Patients with ulcerative colitis managed in urban centres with colorectal surgery were less likely to have complications than when managed in rural settings |
| Quinn and Read, 2017 (80) | Australia | Assessment of pediatric surgical outcomes managed at rural sites in Australia | Complication rates of orchidopexy under the age of 5 years and inguinal hernia under the age of 1 year had the same or nearly the same complication rates as the published gold standard |
| Rinker et al., 1998 (75) | United States | Outcomes of locally performed craniotomy by general surgeons at a level III trauma centre | Based on need, a group of general surgeons completed training for emergency craniotomy by a neurosurgeon In the follow-up, 7 patients required emergency craniectomy as deemed appropriate by a remote neurosurgeon; good clinical outcomes resulted in patients deemed too unstable to transfer to specialized neurosurgical care |
| Rossi et al., 2011 (81) | United States | Assessment of complication rates of procedures completed in critical access hospitals | Review of 100 consecutive carotid endarterectomy, laparoscopic cholecystectomy, laparoscopic Nissen fundoplication, hysterectomy, and inguinal hernia; overall complication rate of 4% |
| Sariego, 2000 (76) | United States | Review of a single rural surgeon’s endoscopic practice | 276 endoscopic procedures were completed; 75% pertinent diagnosis were identified; no complications |
| Treacy et al., 2005 (82) | Australia | Assessment of emergency neurosurgical procedures performed in remote Australia | 305 emergency neurosurgical procedures were completed; overall outcomes were acceptable |