# Patients from Remote Health Centers Referred to Cayenne Emergency Department: A One-Year Observational Study

## TL;DR

This study examines patients transferred from remote health centers to Cayenne's emergency department in French Guiana, highlighting the reasons for transfers and suggesting ways to reduce them.

## Contribution

The study provides insights into the epidemiology and management of emergency transfers in a geographically isolated region.

## Key findings

- The most common reasons for transfer were trauma, digestive, respiratory, and infectious conditions.
- 71% of transferred patients were hospitalized, while 7% required no further examination.
- Air transport was frequently used, even for nonurgent cases, due to geographical constraints.

## Abstract

French Guiana has developed a health organization to respond to its geographical situation. Remote health centers provide primary and emergency care in isolated areas. The limited technical facilities at the remote health centers result in a significant number of patient transfers to the Cayenne emergency department (ED). The objective of this study was to describe the epidemiology and management of patients transferred to Cayenne ED. A retrospective observational study was conducted from January 1 to December 31, 2019, and it included all patients transferred from remote health centers to Cayenne ED. All sociodemographic, prehospital, hospital, and referral data were collected; 842 patients were transferred by remote health centers to the Cayenne ED. The male/female ratio was 1.27, with an age of 36 (±23) years old. The two main modes of transportation used were helicopter (36%) and plane (22%). The most frequent reasons for transfer were trauma (28%), digestive (9%), respiratory (9%), and infectious (8%) conditions. Patients were hospitalized in 71% of cases. Among patients who were not hospitalized, 7% did not require further examination or specialist advice in the ED. Our work underlines the important use of airborne resources, particularly medical ones; they were initially intended for the management of vital emergencies, but they are also used for nonurgent situations. The geography and road access in French Guiana make alternative means of transport difficult. Our work identifies a number of areas for optimizing care to decrease the number of transfers: improving biomedical equipment, improving imaging equipment, and use of telemedicine.