Journal of Emergency Practice and Trauma

Cross-border mountain rescue victims in the central Pyrenees: incidence, hospital pathways, and patient experience

Document Type : Original Article

Authors

Antoine Rouget 1
Miguel Navasal Cortes 2
Emmanuel Gurrera 3
Nicolas Boeschlin 4
Alicia Sanz Cardiel 2
Ayala Marc 2
jules Clouzeau 3
Juan Peres-nievas 2
Jeremie Pichon 5

1 Mountain Rescue Unit, Emergency Department, Centre Hospitalier de Bigorre, Tarbes, France Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France

2 Mountain Rescue Unit, Emergency Department 061 Aragón, SALUD Aragón, Gobierno de Aragón, 50009 Zaragoza, Spain.

3 Mountain Rescue Unit, Emergency Department, Centre Hospitalier de Bigorre, Tarbes, France

4 Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France.

5 -Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France. -Department of Pulmonology, Clinique Pasteur, Toulouse, France

Abstract
Objective: The central Pyrenees form the natural border between France and Spain and attract many outdoor enthusiasts. Cross-border mountain rescues are frequent, yet their medical and logistical consequences remain poorly described. We aimed to quantify the incidence of cross-border rescue victims and assess their hospital pathways, satisfaction, and practical difficulties during care abroad.
Methods: We conducted a retrospective bicentric study (RESCAPYR study) including all consecutive cross-border mountain rescue patients in 2018–2019 (n = 150). Data were obtained from rescue and hospital records. Patients referred to a healthcare facility were contacted for follow-up interviews assessing satisfaction and reported difficulties. Categorical variables were compared using the Chi-square or Fisher’s exact test, continuous variables using the Mann–Whitney U test, and paired satisfaction scores using the Wilcoxon signed-rank test.
Results: In France, 54 Spanish nationals were rescued over two years (5.1–5.6% of annual rescues), while in Spain, 96 French nationals were rescued (12.0–17.2%). Approximately two-thirds required hospitalization in the neighboring country. Median hospital stay was 2 days [1–4] for Spanish patients and 1 day [1–2] for French patients. Satisfaction significantly decreased between the prehospital and hospital phases (p = 0.01 and p < 0.01), without differences between groups. Patients from both countries reported similar difficulties, mainly language barriers, financial concerns, and repatriation challenges.
Conclusion: Cross-border mountain rescues frequently result in hospitalization outside patients’ national healthcare systems and expose them to administrative and communication barriers. Improved cross-border coordination and structured emergency transfer agreements are needed in border regions.

Keywords

Mountain rescue
Cross-border healthcare
Pyrenees
Patient experience
Emergency medicine
Subjects

  • Receive Date 08 January 2026
  • Revise Date 15 February 2026
  • Accept Date 28 May 2026

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