Hospital admissions and 30-day mortality following non-transport ambulance missions in a Norwegian region: A retrospective study

Background Not all ambulance missions require patient transport, as in some cases, patients discharged at the scene may require further examination and treatment. Some factors, like sex, age and psychiatric disease, seem to be factors associated with non-conveyance. This study aimed to identify and characterise patients left at the scene following an urgent ambulance mission and examine subsequent hospital admission and mortality rates. Methods This retrospective study was conducted in the emergency medical system in Norway’s second-largest city. Data were obtained from the Emergency Medical Communication Centre (EMCC) and included information of patients involved in acute or urgent ambulance missions who were left at the scene, during 1 year. The frequency of non-transport, patient demographics, and incidence of hospital admissions within 72 hours was analysed. Furthermore, the 30-day mortality, predictive factors, and reasons for contacting the EMCC were determined. Results A total of 7.3% of patients were discharged at the scene, whereas 5.8% were admitted to the hospital. The 30-day mortality rate among all non-transported patients was 2.4%, whereas 2.1% of hospitalised patients died within 30 days. Psychiatric conditions were frequently observed in both groups. The mortality rate increased significantly with age but was not associated with the number of ambulance requests. Further, the 30-day mortality was not significantly associated with sex, time of day, day of the week, or rurality. Conclusions The hospital admission and mortality rates among patients left at the scene suggest that the factors influencing non-transportation decisions, and the safety of such decisions warrant further investigation. Subsequent events following patient discharge should be routinely collected by ambulance services and monitored for learning and improving quality of patient care.