[Attendance pattern at an open casualty ward in Greater Copenhagen]

To analyse the use of a casualty department in Copenhagen, we prospectively analysed all contacts to the casualty department at Hvidovre Hospital during a period of four weeks. There were 3908 contacts and 3851 of these were accessible for registration with a full record (98.5%). The mean intake was 130 patients per 24 hours. Sixty eight percent were seen within 24 hours of the accident or onset of serious symptoms of illness, 22% were admitted by ambulance. A total of 680 patients (18%) came to the hospital rather than their general practitioner for reasons of convenience. Only one third of the patients presented an orthopaedic problem. Twenty-five percent of the patients presented a problem, which properly should have been dealt with by their general practitioner. Eight hundred and forty-seven (22%) of the contacts were unnecessary. Like most other hospitals in Denmark, all patients at Hvidovre casualty department are evaluated by a junior orthopaedic surgeon. By establishing a possibility for primary evaluation and proper distribution of patients by an older and more broadly educated colleague, it should be possible to eliminate approximately 30% of the attendances from the emergency department and there by give better time and treatment for those in real need of help.