Patient flow in burn care: a population-based analysis of hospital admissions and transfers in Norway, a Western European healthcare system

• 27% reduction in hospital days for burns in Norway in 2022, relative to 2012. • Children < 2 years are more than twice as likely to be transferred to the NBC. • Increased centralisation – 45% of all hospital days for burns at the NBC. Burn injuries represent a considerable trauma burden. In Norway (population 5.4 million), major burns are treated at a single National Burn Centre (NBC), with supplementary care provided at five regional hospitals with burn services and at 40 local hospitals. This study aimed to examine in detail the epidemiology and patient flow between hospitals and determine whether specific groups are transferred more frequently between levels of care. We conducted a register-based study using the Norwegian Patient Registry to identify all inpatient burn cases in 2022 (ICD-10: T20–25, T29–32). Hospitals were classified into three care levels (NBC, regional with burn services, and local). Logistic regression was used to assess age-related transfer patterns. In 2022, 825 patients with burns were admitted across 46 Norwegian hospitals (incidence: 15.2/100,000/year), requiring 5,553 hospital days. The median length of stay was 3 days, and 76% were discharged within 1 week. Overall, 16% of patients were transferred to higher-level care, mainly within the first day. Children under two years had more than double the odds of transfer (OR 2.11, 95% CI 1.28–3.44). Burn care in Norway is increasingly centralized, with 45% of all hospital days spent at the National Burn Centre. Young children are significantly more likely to be transferred.