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Method

All A& E departments in the Netherlands that were operational for 24 hours a day, 7 days a week in December 2012 were approached (n= 93) and the following data were collected over 2012: the total number of patients, the number of hospital admissions through the A & E department, and the number of self-referrals.

Results

Data were obtained from 96% emergency departments (n= 89) throughout the Netherlands, including all 8 university medical centres and 28 hospitals of the association of tertiary medical teaching hospitals (STZ). In 2012 a total of 1,989,746 people attended the 89 emergency departments. The average percentage of hospital admissions from an A & E department was 32% nationwide (range: 8-54). The average percentage of self-referrals to the emergency departments was 30% nationwide (range: 3-76).

Conclusion

The number of attendees at A & E, the admission rate through the A & E department and percentage of self-referrals in 2012 showed a range of variation nationwide. The number of people attending A & E has not increased over the last few years and is low in international terms. On average one-third of people attending A & E were admitted. In contrast with prevailing national beliefs, a minority of attendees at A &E departments were self-referrals.