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Article

Hospital Admissions and 30-Day Mortality Following Non-Conveyance Ambulance Missions in a Norwegian Region: A Retrospective Study

by
Kjersti Amundsen
1,2,†,
Marie Svanes Elden
1,2,†,
Lars Myrmel
1,
Jörg Assmus
3,
Audun Lange
4 and
Guttorm Brattebø
1,2,5,*
1
Department of Anaesthesia & Intensive Care, Haukeland University Hospital, N-5021 Bergen, Norway
2
Department of Clinical Medicine, University of Bergen, N-5021 Bergen, Norway
3
Centre for Clinical Research, Haukeland University Hospital, N-5021 Bergen, Norway
4
Department of Service Innovation, Haukeland University Hospital, N-5021 Bergen, Norway
5
Norwegian National Advisory Unit on Emergency Medical Communication, Haukeland University Hospital, N-5021 Bergen, Norway
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Emerg. Care Med. 2026, 3(1), 3; https://doi.org/10.3390/ecm3010003
Submission received: 14 November 2025 / Revised: 8 January 2026 / Accepted: 19 January 2026 / Published: 23 January 2026
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Abstract

Background: Not all ambulance missions result in patient transport, often referred to as non-conveyance. However, in some cases, patients discharged at the scene may require further examination and treatment. Patient sex, age, and psychiatric disease seem to be factors associated with non-conveyance. This study aimed to identify and characterise patients not transported following an urgent ambulance mission, and to examine subsequent hospital admission and mortality rates. In addition, we wanted to examine their reasons for calling the Emergency Medical Communication Centre (EMCC). Methods: This retrospective study was conducted for the emergency medical system of Norway’s second-largest city. Data, including information from non-conveyed patients involved in acute or urgent ambulance missions over 1 year, were obtained from the EMCC. The frequency of non-conveyance, patient demographics, and incidence of hospital admissions within 72 h were analysed. Furthermore, the 30-day mortality, predictive factors, and reasons for contacting the EMCC were determined. Results: Out of a total of 22,183 ambulance missions, 7.3% of patients were not conveyed, of whom 5.8% were admitted to hospital within 72 h. The 30-day mortality rate among all non-conveyed 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. Furthermore, 30-day mortality was not significantly associated with sex, time of day, day of the week, or rurality. Conclusions: Our data suggests that there is no difference between the short-term outcomes of non-conveyed and conveyed patients; both groups are equally likely to come to harm. Therefore, the factors influencing non-transportation decisions warrant further investigation. Subsequent events following patient discharge should be routinely collected by ambulance services and monitored for learning and to improve the quality of patient care.

1. Introduction

Patients requiring acute care rely on the emergency medical system (EMS)’s capacity and availability [1,2]. As EMS demand increases, minimising unnecessary ambulance transports and avoiding overcrowding in emergency departments (EDs) are crucial [3]. On the other hand, those patients who need acute treatment should be identified. Non-conveyance can be defined as a situation in which a patient for whom an ambulance was dispatched returns without the patient onboard. Expecting that prehospital providers consistently make accurate decisions without the diagnostic tools available in the ED is unrealistic [4]. This places responsibility on ambulance personnel and challenges their competence in making such decisions independently. Non-conveyance rates vary widely, ranging between 4% and 94% [5,6].
Studies have shown that ambulance personnel under-triage patients in some cases, whereas many transports to the ED are unnecessary [4,7]. The occurrence of serious adverse events after non-conveyance is reported to be <1% [6]. Large overtriage is not cost-effective and may delay care for other patients [2]. However, ambulance non-conveyance leading to delayed diagnosis and treatment may result in more severe illness or even mortality. An Australian study reported a 7-day mortality rate of 0.5% for patients released at the scene compared with 0.3% for those transported to the ED [8].
Although ambulance personnel are trained to recognise critical conditions and initiate appropriate treatment and transport patients, various factors can influence the decision of non-conveyance. These include several conditions (both chronic and non-chronic), patient/family preferences, the availability of alternative referral options, policies, staff expertise, and risks associated with hospital admissions [5,9,10,11]. Hence, more information is needed to improve the accuracy of non-conveyance decisions made by the EMS.
A patient with a serious condition (e.g., sepsis) but with few symptoms may call for an ambulance but end up not being conveyed. One could suspect that the condition would worsen and result in subsequent hospitalisation within the next few days.
To address this possible organisational gap, this study aimed to identify and characterise non-conveyed patients, as well as to examine their reasons for calling the EMCC. Hospital admission within 72 h and one-month survival rates were also investigated.

2. Materials and Methods

2.1. Study Design

This was a retrospective observational study of registry data from the Bergen EMCC.

2.2. Setting

The Bergen Health Trust (BHT) includes 17 ambulance stations and one EMCC serving 24 municipalities with a total population of 455,000 inhabitants [12]. It is the sole EMS provider in the region and is responsible for all types of ambulance missions. The area has three hospitals, including one private hospital, covering approximately 30% of the population, and admits general medical patients and those with certain orthopaedic conditions (e.g., patients not requiring invasive coronary; major trauma; gynaecological/obstetric; paediatric; ophthalmology; and ear, nose, and throat interventions). Data from all three hospitals were included. BHT ambulance personnel use the South African Triage Scale, a standardised triage system for evaluating patients after they have been examined [13]. This system has four urgency categories. No specific guidelines exist for non-conveyance decisions. However, protocols are in place for a few conditions (e.g., drug overdose, hypoglycaemia, and seizures). Although ambulance personnel may decide not to transport a patient, consulting a doctor remains standard practice. It is important that such guidelines are both in place and followed.
Although all missions ending in non-conveyance are recorded in the EMCC, the decision to release patients is made by on-scene ambulance personnel in a very few instances (e.g., successfully treated hypoglycaemia in known diabetic patients).

2.3. Norwegian EMS

The Norwegian EMS operates within a two-tier system, where patients are typically seen by a general practitioner (GP) (first tier) before hospital admission. According to the law, every municipality should have a GP on call at any time. This is the “back-bone” of the EMS. Then there is the ambulance service, including air-ambulance and prehospital emergency physicians, which constitutes the second tier. However, the EMCC can also directly dispatch ambulances following emergency calls [14]. The ambulance personnel are either paramedics, emergency technicians, or specially trained nurses. There are national standards, but the required minimum competency level is vocational training certification. In cases of non-conveyance, most often the GP or the emergency physician on-call or the air-ambulance should be consulted. The EMCC operators are specially trained registered nurses, ambulance personnel, or paramedics, using criteria from the Norwegian Index for Medical Emergency Assistance to support decision-making [15]. This system is designed for telephone triage, and emergency calls are prioritised into three categories: “acute”, “urgent”, and “regular”. The latter is most often used for transport between facilities and returns from hospitals. In such circumstances, non-conveyance is seldom the result. Additionally, calls are also categorised using index codes based on the main complaint or reason for requesting an ambulance.

2.4. Study Population

All patients in the “urgent” and “acute” triage groups over 1 year were analysed.

2.5. Data Sources

Data on all ambulance missions over 12 consecutive months (January–December 2018) were extracted from the EMCC Electronic Database (Acute Medical Information System). The data included index codes, urgency level, time, location, patient sex, age, transport status, and the facility to which the patient was transported. The data were linked to the hospitals’ patient record systems to identify ambulance missions that resulted in non-conveyance. Patients admitted to the hospital within 72 h and 30-day mortality after non-conveyance ambulance missions were also identified. Other clinical information was unavailable, as vital signs are documented in paper-based patient records and not in the ambulance dispatch system.

2.6. Statistical Analysis

The data files were de-identified prior to statistical analysis and evaluation. Descriptive methods, including proportions and interquartile ranges (IQRs), were used to characterise the missions and patients.
Demographic variables such as sex, age, time of day, day of the week, type of municipality, and urgency classification were analysed. The municipalities were categorised as “urban” (n = 1), “semi-urban” (n = 3), or “rural” (n = 20). The primary reason for requesting an ambulance was categorised according to the EMCC index code [10]. For patients admitted to the hospital within 72 h, the primary cause of admission, classified according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), was recorded. Information was also collected to determine whether a doctor was present or consulted prior to the non-conveyance decision, along with the recorded reasons for the decision. Specific causes of death were not assessed as death certificates were not reviewed, but mortality could be recorded from the national census registry.
Finally, factors associated with 30-day survival were assessed on the basis of several predictors: age, sex, time of day, day of the week, municipality type, degree of urgency, and total number of missions for each patient ending in non-conveyance. For patients with repeated requests, the last registered request was used as the starting point to avoid immortal time bias.
Survival data were analysed using the Kaplan–Meier method, with differences between groups tested using the log-rank and Gehan–Breslow tests. Owing to the low number of events, multivariable models were not estimated. A p-value of <0.05 was considered statistically significant. The data were analysed using SPSS 26 (IBM Corp, Armonk, NY, USA) and R ver. 4.4.0 [16], and graphics were generated using Matlab 9.0 (MathWorks Inc., Natick, MA, USA).

3. Results

3.1. Non-Conveyance Rates

The dataset included 33,183 ambulance missions, of which 2416 (7.3%) involved patients who received urgent or acute ambulance missions and were released at the scene (Figure 1). Table 1 presents the characteristics of all included ambulance missions and those that ended in non-conveyance, patients admitted to the hospital within 72 h after a non-conveyance, and patients who died within 30 days after a non-conveyance. Each registered request was counted; that is, patients with repeated requests appeared more than once. A greater proportion of non-conveyed patients were men, with a median age of 47 years (IQR: 28–70 years), compared with 64 years (IQR: 39–80 years) for all included ambulance missions. Table 2 presents the index code selected by the EMCC operator based on the signs and symptoms reported during emergency medical calls, showing that injuries or fractures and respiratory problems accounted for one out of three calls.

3.2. Hospital Admission and Mortality

Within 72 h of the non-conveyance ambulance mission, 140 (5.8%) of these patients were admitted to the hospital. In this group, 56% were women, with a median age of 59 years (IQR: 35–76 years; Table 1). Table 3 presents the distribution of ICD-10 categories for these patients, as recorded by the receiving doctor at the admitting hospital, and Table 4 shows the index codes recorded by the EMCC at the time of ambulance request.
Table 3. Distribution of ICD-10 categories recorded by the receiving hospital upon admission.
Table 3. Distribution of ICD-10 categories recorded by the receiving hospital upon admission.
ICD-10-Chaptern (%)
Chapter V (mental and behavioural disorders)31 (22.1%)
Chapter IX (diseases of the circulatory system)21 (15.0%)
Chapter X (diseases of the respiratory system)17 (12.1%)
Chapter VI (diseases of the nervous system)15 (10.7%)
Chapter XI (diseases of the digestive system)12 (8.6%)
Chapter XIX (injury, poisoning, and certain other consequences
of external causes)		12 (8.6%)
Other *11 (7.9%)
Chapter XIV (diseases of the genitourinary system)8 (5.7%)
Chapter XVIII (symptoms, signs, and abnormal clinical and laboratory
findings)		7 (5.0%)
Chapter IV (endocrine, nutritional, and metabolic diseases)4 (2.9%)
Unknown2 (1.4%)
Total140 (100%)
* Other included chapters: chapters I (infectious diseases), II (neoplasms), III (diseases of the blood), VII (diseases of the eye), XII (diseases of the skin), and XIII (diseases of the musculoskeletal system).
Ecm 03 00003 g001
Figure 1. Flowchart showing the patient selection process.
Figure 1. Flowchart showing the patient selection process.
Ecm 03 00003 g001
Table 4. Characteristics of non-transport missions leading to hospital admission within 72 h or death within 30 days.
Table 4. Characteristics of non-transport missions leading to hospital admission within 72 h or death within 30 days.
Death
Within
30 Days
(59 Patients)		Hospital Admission
Within 72 h (140 Patients)
Index group recorded by EMCC for ambulance requestn (%)n (%)
Breathing difficulties or lung diseases15 (25.4%)27 (19.3%)
Injuries11 (18.6%)20 (14.3%)
Syncope or altered level of consciousness10 (16.9%)15 (10.7%)
Psychiatric disorders or intoxication7 (11.8%)32 (22.9%)
Neurological disorders or convulsions5 (8.4%)11 (7.9%)
Heart and circulatory diseases4 (6.8%)21 (15.0%)
Diabetes 2 (3.3%)4 (2.8%)
Other *5 (8.4%)10 (7.1%)
Doctor present at the scene or consulted by phonen (%)n (%)
Present17 (28.8%)29 (20.7%)
Consulted with29 (49.1%)78 (55.7%)
Not present or consulted with9 (15.3%)24 (17.1%)
Unknown4 (6.8%)9 (6.4%)
Reason for non-transportn (%)n (%)
Treated at the scene24 (40.1%)67 (47.8%)
Improvement before or when ambulance arrival4 (6.8%)26 (18.6%)
Patient did not want transport15 (25.4%)32 (22.8%)
Pre-terminal2 (4%)1 (0.7%)
Unknown14 (23.7%)14 (10.0%)
* Other included conditions: assistance for nursing home, message of concern, infections, and abdominal pain.
As shown in Table 4, 3 (2.1%) of the 140 patients hospitalised within 72 h died within 30 days after a non-transport mission, whereas among the non-conveyed patients, 59 (2.4%) died within 30 days. The median age of these patients was 83 years (IQR: 73–90 years) The mortality rate after a non-conveyance mission was significantly associated with age, and increased with increasing age (Figure 2, left panel); however, this did not correlate with a greater number of ambulance requests ending in non-transport (Figure 2, right panel). Furthermore, 30-day mortality was not associated with sex, time of day, day of the week, or rurality. In most non-conveyance decisions, a doctor was either present or consulted; however, in 15% of patients, the decision was made solely by the ambulance personnel. In 39% of the missions in our study, patients resided at a nursing home with 24 h nursing care, and a doctor was available during the day. In 15% of non-conveyance missions, patients received palliative care.

4. Discussion

We found a non-conveyance rate of 7.3% for this health trust. Notably, only acute or urgent code missions were included, indicating that the EMCC determined a certain level of urgency for each situation. The “regular” calls (27% of all missions) were excluded, as these calls are often transports between facilities and returns from hospitals. Studies have reported non-transport rates of 40% in Finland, 38% in the United Kingdom (UK), 26% in the Netherlands, 16% in Australia, 14–20% in Sweden, and 13% in Denmark [11,17,18,19,20]. In comparison, the non-conveyance rate in this study was low. No consensus exists regarding the optimal non-transport rate for ambulance services, as the indications for ambulance transport vary between systems. Further modelling of the cost-effectiveness, safety, and appropriateness of non-conveyance is needed [10]. Guideline adherence also remains a critical issue in the prehospital care setting [21].
The non-conveyed patients were often males and tended to be younger. Other Nordic studies have described a greater probability of non-conveyance among women and younger patients [11,16]. Other studies have reported no sex differences, although in one of those studies, the non-conveyance group was significantly younger (mean age: 48.5 years vs. 60.7 years for all missions) [19,22]. Older patients often present with frailty, comorbidities, and severe diseases, combined with a reduced ability to cope with emergencies [23]. This may explain their greater likelihood of being transported to the hospital. In contrast, older and chronically ill patients might refuse ambulance transport due to prior hospital visits, despite a higher mortality risk. Also, elderly patients may refuse transport, although someone in their family or others may have called the emergency number with the best intentions. Regretfully, we did not have access to information on who made the call to the EMCC in these cases.
In our study, most non-conveyed patients had injuries or fractures, followed by breathing difficulties and reduced consciousness. Although it is disturbing if a patient with stroke symptoms is left at the scene, the index criteria used by the EMCC do not discriminate between altered consciousness (e.g., drunkenness) and stroke. However, this should be investigated, as it is obvious that a stroke patient should be transported. A Swedish study reported that most non-conveyed patients had non-specific or related psychiatric disorders; in the Netherlands, the most common reasons for non-conveyance were diseases of the circulatory system (ICD-10:9), injuries or poisoning (ICD-10:19), or mental, behavioural, and neurodevelopmental disorders (ICD-10:5) [19,20].
In Norway, an index category must be assigned to all conditions by the EMCC; sometimes, this does not provide an accurate description of the patient’s actual condition. Our study identified several reasons for non-conveyance, including patient refusal to be transported to a doctor. In such cases, the ambulance personnel’s responsibility is to inform the patient about the necessity for hospital admission and potential adverse outcomes of requesting to be discharged at the scene. Importantly, subsequent contact after a decision for non-conveyance does not automatically mean that patient safety is compromised, as patients may be followed up by other parts of the health care system. However, the final decision of not transporting a patient rests in the hands of the health personnel who examined the patient face-to-face.
Variation in competency may also influence the proportion of non-conveyance decisions. However, we had no access to information on the individual skill levels of the EMS personnel.

4.1. Subsequent Hospital Admission

In missions resulting in non-conveyance, 140 (5.8%) patients were admitted to the hospital within 72 h. Similar higher hospital admission rates have also been reported. A UK study reported that 6.8% of patients were admitted to the hospital within 72 h following a non-conveyance mission, whereas an Australian study reported a hospital admittance rate of 2.4% within 72 h after non-conveyance [6,18]. Other studies have reported upper event rates of 10% within 72 h [8,18]. One Australian study revealed an increased risk of subsequent events among patients discharged at the scene compared with patients transported and later discharged from the ED, with 3.3% admitted to a hospital within 24 h after non-conveyance and 0.8% subsequently admitted to a hospital after being transported and discharged from the ED [8].
A comparison of the index codes assigned by the EMCC to the ICD-10 categories recorded by the receiving doctor at the corresponding hospital allowed for an assessment of whether the cause of later admittance aligned with the reason for the initial ambulance request. Patients with psychiatric disorders and mental and behavioural changes represented the largest groups in both instances. Cardiovascular and respiratory diseases were also common causes of ambulance requests and hospital admissions, indicating a strong correlation between patients’ reasons for contacting the EMCC and their subsequent hospital admissions. However, further investigation is needed to determine whether these causes align with individual cases.
A high proportion of patients with psychiatric disorders were admitted to the hospital within 72 h of being left at the scene by ambulance personnel. One study in the United States (US) found that 30% of psychiatric patients treated in the ED were readmitted to the hospital within 30 days [24]. These patients may be vulnerable, and their conditions are often complex [5,6]. They may have problems describing their symptoms and complaints. One way to interpret our results is to suggest that alternative care options, such as interventions by mental health acute assessment teams, may be more appropriate for these patients [25].
If patients who were admitted to the hospital within 72 h had been admitted at first contact, disease complications might have been avoided; however, identifying these patients is challenging. Transport during the initial mission could also prove more cost-effective for health services, because treating a condition early on would most likely be less costly than later in the course of the disease (e.g., for sepsis patients). However, the patient’s condition might have worsened within 72 h after discharge, leaving these arguments merely speculative. A thorough evaluation of whether the right decision was made in individual patients requires further investigation to determine whether the initial reason for contacting the EMS matched the reason for admission within 72 h.
Ambulance personnel may also instruct a patient to visit the hospital by himself immediately, e.g., in a suspected case of appendicitis that needs ED assessment but not ambulance transport. This could be by private transport and is absolutely an option in our system. However, the EMCC should have been informed; often, the GP on-call is involved.

4.2. Mortality

Among patients discharged at the scene, the 30-day mortality rate was 2.4%, with most cases involving consultation with a physician. This suggests that some level of responsibility lies with the physician; however, when ambulance personnel consult a physician over the phone, they must still examine and evaluate the situation thoroughly to provide accurate information.
A study from the US compared 30-day mortality rates after EMS missions and reported 5% and 1% mortality rates among transported and non-transported patients, respectively [26]. This finding supports our hypothesis that transported patients tend to have more severe illnesses. However, the study had a small sample size, with only two patient deaths. These results align with our findings, showing 30-day mortality rates of 4% among patients involved in all ambulance missions and 2.4% among non-transported patients. A systematic review assessing the safety of non-transported patients, particularly those focused on mortality, revealed several studies reporting death rates ranging from 0% on day 1 to 2.3% after two weeks [17]. Another systematic review reported a 30-day mortality rate of up to 1.6% [5]. Additionally, a prospective study from Iran reported a 1-year mortality rate of 5% following a non-transport decision [27].
Most patients who died within 30 days after a non-transport mission in our health trust department were older than 80 years, with a mortality rate of 8.8%. More than three out of four of those who died within 30 days were older than 60 years. Similarly, other studies reported a higher incidence of mortality among elderly patients discharged at the scene [18]. For cases concerning patients in palliative care, the decision not to transport the patient was likely based on the treatment already provided, sparing the patient from the burden of another hospital admission. The 30-day mortality rate in our study may have increased due to the inclusion of these patients.
Determining whether a patient’s death could have been postponed or avoided had the patient been transported is very difficult, as death may have resulted from causes unrelated to the ambulance mission. An Australian study reported a very low rate of adverse events among paediatric patients not transported to the ED [28]. The authors suggested that a newly introduced “red flag” clinical practice guideline, which strongly advocates transport to a hospital, might have influenced this outcome. Another Australian study reported similar findings [6]. One Iranian study concluded that the acceptability of the mortality rate in such situations depends on the actual cause of death [29]. This factor holds significance in our study. Further investigation into the cause of death is necessary to better understand whether leaving the patient at the scene was appropriate. Differences in healthcare systems also play a role in providing insights. Failure to consult a doctor regarding more than 15% of the patients left at the scene, who subsequently died within 30 days, cannot be attributed to operational conditions and warrants further investigation.
One could argue based on our results that costs are taking precedence over patient care, which is not the intention. However, we cannot deny that a “cost-containing” mindset of EMS personnel could influence decisions of non-conveyance in our EMS.

4.3. Limitations

As a retrospective study, the results were based on data documented in an electronic mission record system. Despite this, important data like vital signs or other detailed clinical information for each patient were not available. Owing to the manual entry of documentation, important information may have been omitted or inaccurately recorded. Moreover, several records were incomplete. A total of 2689 missions lacked patient IDs and were excluded, thereby reducing the size of the dataset. Notably, 1420 missions without a patient ID did not result in transport, representing a significant proportion (37%) of non-conveyance patients. Evidence suggests that drug use disorders constitute a large proportion of this group. Given that we do not know the hospital admittance or mortality rates for this group, bias may have been introduced.
Another limitation involves the inclusion of palliative patients in the 30-day mortality group. Additionally, some patients receiving end-of-life care may not have been detected or excluded, as this information was not routinely recorded. This may have affected the estimated rates in both instances. However, as only acute or urgent missions were included, a certain degree of urgency likely existed in this situation.
Mortality and hospital admission rates within a specific period served as indicators of adverse outcomes in non-transported patients. The inability to access the National Death Registry prevented us from determining the specific causes of death, limiting our ability to assess whether the cause of death was related to the original reason for the ambulance mission. Using an event period shorter than 72 h may increase the likelihood of subsequent events being associated with non-transport decisions.
Finally, this retrospective study was conducted on data from 2018, within a specific EMS organisation in one Norwegian city, limiting the generalisability of the results to countries with different healthcare system structures. The sample size could also have been larger. Also, our study has uncovered knowledge gaps, and therefore, non-conveyance decisions should be based on objective and validated criteria.

5. Conclusions

Analysing more than 20,000 ambulance missions, our study found that 1 out of 14 patients were not conveyed to the hospital, of whom 5.8% were admitted to the hospital within three days (72 h). Mortality following non-conveyance missions compared to those transported was similar. The mortality rate increased with age, but not with the number of requests, sex, time of day, day of the week, or rurality. The exact relationship between subsequent events and non-conveyance remains uncertain, and the cause-and-effect relationship between non-conveyance and mortality also remains unclear. Our data suggests that there is no difference between the short-term outcomes of non-conveyed and conveyed patients, as both groups are equally likely to come to harm. Subsequent events following patient discharge at the scene should be routinely collected by ambulance services and monitored for learning and improving the quality of patient care.
The specific factors influencing the decision not to transport a patient, particularly regarding the safety of these decisions, especially the need for physician involvement, must be elucidated. Also, we recommend the implementation of “non-conveyance guidelines”, and ambulance services should routinely receive information about subsequent events following non-conveyance.

Author Contributions

Conceptualisation, K.A., M.S.E. and G.B.; methodology, K.A., M.S.E., G.B. and L.M.; software, J.A. and L.M.; validation, L.M. and A.L.; formal analysis, L.M., K.A., M.S.E., G.B. and J.A.; data curation, L.M. and A.L.; writing—original draft preparation, K.A., M.S.E. and G.B.; writing—review and editing, G.B.; supervision, G.B.; project administration, G.B. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.

Institutional Review Board Statement

The study was approved by the research ethical committee in health region south-east (No. 2018/1641/REK Sør-Øst, approval day: 10 January 2018).

Informed Consent Statement

According to national regulations, quality studies require only approval from a hospital or data protection officer. The data were stored on a secure server, and a de-identified analysis file was constructed.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors on reasonable request.

Acknowledgments

The authors thank Haraldsplass Deaconess Hospital and Helse Vest IKT for making data available for analysis.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

EMCCEmergency Medical Communication Centre
EMSsEmergency Medical Services
EDEmergency Department
BHTBergen Health Trust
ICD-10International Statistical Classification of Diseases and Related Health Problems, 10th Revision
IQRinterquartile range
UKUnited Kingdom
USThe United States of America

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Ecm 03 00003 g002
Figure 2. Survival (Kaplan–Meier) curve during the first 30 days after discharge at the scene according to age and number of ambulance requests.
Figure 2. Survival (Kaplan–Meier) curve during the first 30 days after discharge at the scene according to age and number of ambulance requests.
Ecm 03 00003 g002
Table 1. Patient’s baseline characteristics.
Table 1. Patient’s baseline characteristics.
VariableAll Included Missions Non-Transport Missions Number of Hospital Admissions Within 72 h Among Those Not TransportedNumber of Deaths * Within 30 Days Among Those Not Transported
n = 33,183n = 2416n = 140n = 59
Sex
  Male17,236 (52%)1365 (57%)62 (44%)33 (56%)
  Female15,947 (48%)1051 (43%)78 (56%)26 (44%)
Age in years
  Median (IQR) **64 (39–80)47 (28–70)59 (35–76)83 (73–90)
  <202494 (8%)284 (12%)15 (10%)0
  20–6012,647 (38%)1309 (54%)52 (37%)6 (10%)
  >6018,042 (54%)823 (33%)73 (52%)53 (77%)
Time of day
  Day (7–19)19,722 (59%)1131 (47%)83 (59%)30 (51%)
  Night (19–7)13,461 (41%)1285 (53%)57 (41%)29 (49%)
Day of the week
  Monday–Thursday18,637 (56%)1261 (52%)72 (51%)26 (44%)
  Friday–Sunday14,546 (44%)1155 (48%)68 (49%)33 (56%)
Triage group (urgency)
  Acute14,326 (43%)1212 (50%)71 (51%)35 (59%)
  Urgent18,857 (57%)1204 (50%)69 (49%)24 (41%)
Municipality type
  Urban 21,838 (66%)1475 (61%)78 (56%)33 (56%)
  Semi-urban 4254 (13%)389 (16%)23 (16%)10 (17%)
  Rural7091 (21%)552 (22%)39 (28%)16 (27%)
30-day mortality4.0%2.4%2.1%
* Deaths are recorded in the national census and linked to the hospital’s electronic patient record system. ** Interquartile range.
Table 2. Reasons for requesting an ambulance in all non-transport missions.
Table 2. Reasons for requesting an ambulance in all non-transport missions.
Index Code Assigned by EMCC * Based on the Nature of Telephone Calln (%)
Injuries or fractures538 (22.3%)
Breathing difficulties or lung diseases374 (15.4%)
Stroke or altered level of consciousness 191 (7.9%)
Fire or electrical injuries182 (7.5%)
Psychiatric disorders or intoxication170 (7.0%)
Unconsciousness138 (5.7%)
Hypothermia106 (4.4%)
Cardiovascular diseases104 (4.3%)
Seizures 62 (2.6%)
Non-specific424 (17.5%)
Other **127 (5.2%)
Total2416 (100%)
* Emergency medical communication centre ** Other included conditions: allergic reaction; sick child; stomach pain; infection; diabetes; gynaecology and obstetrics; urinary tract; headache; skin/rash; bite/stick; ear, neck, and throat; eye diseases; and violence or abuse.
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MDPI and ACS Style

Amundsen, K.; Elden, M.S.; Myrmel, L.; Assmus, J.; Lange, A.; Brattebø, G. Hospital Admissions and 30-Day Mortality Following Non-Conveyance Ambulance Missions in a Norwegian Region: A Retrospective Study. Emerg. Care Med. 2026, 3, 3. https://doi.org/10.3390/ecm3010003

AMA Style

Amundsen K, Elden MS, Myrmel L, Assmus J, Lange A, Brattebø G. Hospital Admissions and 30-Day Mortality Following Non-Conveyance Ambulance Missions in a Norwegian Region: A Retrospective Study. Emergency Care and Medicine. 2026; 3(1):3. https://doi.org/10.3390/ecm3010003

Chicago/Turabian Style

Amundsen, Kjersti, Marie Svanes Elden, Lars Myrmel, Jörg Assmus, Audun Lange, and Guttorm Brattebø. 2026. "Hospital Admissions and 30-Day Mortality Following Non-Conveyance Ambulance Missions in a Norwegian Region: A Retrospective Study" Emergency Care and Medicine 3, no. 1: 3. https://doi.org/10.3390/ecm3010003

APA Style

Amundsen, K., Elden, M. S., Myrmel, L., Assmus, J., Lange, A., & Brattebø, G. (2026). Hospital Admissions and 30-Day Mortality Following Non-Conveyance Ambulance Missions in a Norwegian Region: A Retrospective Study. Emergency Care and Medicine, 3(1), 3. https://doi.org/10.3390/ecm3010003

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