Background: Swedish Emergency Departments (EDs) see 2.6 million visits annually. Sweden has a strong tradition of health care databases, but mode of arrival to the ED is not documented in any registry. The situation is similar in most of Europe.
The aim of the study was to provide a national overview of the mode of arrival, medical acuity according to triage, chief complaints, and hospital admission rates for adult patients (≥18 years) visiting Swedish EDs during 24h.
Methods: A national cross-sectional study including all patients at 43 of Sweden’s 72 EDs during 24 hours on April 25th, 2018.
Mode of arrival, medical acuity at triage, admission and basic demographics were registered by dedicated assessors present at every ED for the duration of the study. Descriptive data are reported.
Results: A total of 3875 adult patients (median age 59; range 18 to 107; 50% men) were included in the study. Complete data for mode of arrival was reported for 3693 patients (98%). The most common mode of arrival was self-referred walk-in (n=1310; 34%), followed by ambulance (n=920; 24%), referral from a general practitioner (n=497; 13%), and telephone triage referral by the national healthcare guide service “Healthcare Guide 1177” (n=409; 10%). In patients 18 to 64 years, self-referred walk-in was most common, whereas transport by ambulance dominated in patients >64 years.
Of the 3365 patients that received an acuity level at triage, 4% were classified as Red (Immediate), 18% as Orange (very urgent), 47% as Yellow (Urgent), 26% as Green (Standard), and 5% as Blue (Non-Urgent).
Patients presented with very diverse complaints but about a quarter had abdominal or chest pain.
Overall, the admission rate was 27%. Arrival by ambulance was associated with the highest rate of admission (486 of 920; 53%), self-referred walk-in and telephone triage referrals were less often admitted.
Conclusion: Self-referred walk-in was the overall most common mode of arrival followed by ambulance. Patients arriving by ambulance were often elderly, critically ill and were often admitted to in-patient care, whereas arrival by self-referred walk-in was more common in younger patients.