Aims/Background Emergency care is being provided to, and utilised by, Ugandan patients despite there being no formal system capable of producing optimal outcomes. For the country’s emergency care system to be appropriate and contextualised, there must first be an understanding of the actual utilisation of emergency care services. Current coding systems for analysing and comparing disease burden across sites do not adequately represent the patient population and resources required for quality emergency care to be delivered.

Objective To describe the burden of disease, acuity and management of emergency patients presenting to secondary Ugandan health facilities.

Methods/Design A retrospective review of 4704 emergency care patient charts from November 2018 to April 2019 was performed from 11 sites throughout Uganda. A novel diagnosis coding system was developed for use in LMIC emergency care context consisting of 482 codes, 158 sub-categories and 7 disease classes.

Results 6506 diagnoses were recorded, 34.98% of patients had 2 or more diagnoses. 33.8% were conditions of non-infective origin, 30.1% conditions of infective origin and 25.7% injury. Top 5 diagnoses were malaria, anaemia, pneumonia, head injury and soft tissue injury. Patient charts documented triage in 0.13% of cases, at least 1 vital sign in 42.3% of cases and at least 1 form of examination in 41.4% of cases. 62.3% patients had at least 1 form of investigation. 73.2% of patients received an IV treatment, most commonly antibiotics (52.5%) and IV crystalloids (33.1%).

Conclusion This is the first study of all-cause disease burden and management of emergency patients presenting across multiple Ugandan facilities. The development and application of an emergency care specific diagnostic coding system applicable to LMICs is a vital step to enable understanding and comparison across facilities. By appreciating the burden of emergency care disease, strategies can be put in place to implement an integrated emergency care system in Uganda.