Notes on the data: Emergency department presentations

Emergency department presentations, 2018/19

 

Policy context:  Public hospital emergency departments (ED) are accessible 24 hours a day, seven days a week, to provide acute and emergency care to patients arriving either by ambulance or by other means. While some people require immediate attention for life threatening conditions or trauma, most require less urgent care.

Timely access to care is a high priority for patients, health care providers and the public at large. Although there needs to be an appropriate balance between primary and acute care, EDs play an important role as a safety net in the health system, providing care to people who are unable to access services elsewhere (especially after hours) including care from general practitioners [1]. Young children and people aged 65 years and over are over-represented among those accessing EDs, as are people who are homeless or transient.

The Australian Institute of Health and Wellbeing report that in 2018-19 there were 294 public hospitals that have purpose-built emergency departments which responded to 8.4 million presentations or 22,900 presentations each day. This has increased from an average of 20,200 presentations each day in 2014-15 an increase of 3.2% a year [2].

An ED service event can be commenced by a doctor, nurse, mental health practitioner or other health professional, when investigation, care and/or treatment is provided in accordance with an established clinical pathway defined by the ED [3]. The data include both presentations at formal EDs and emergency occasions of service provided through other arrangements, particularly in smaller hospitals located in regional and remote areas.

Caveat:   Although there are national standards for data on non-admitted patient ED services, the way those services are defined and counted varies across states and territories and over time [4]. One of the most notable variations is the very large number of hospitals in New South Wales with ED services categorised as ‘Other hospitals’. All but one of the 87 hospitals in this category providing ED services were in New South Wales; in comparison, the large majority of public acute hospitals providing ED services in other states and territories were in one of the categories of Public acute hospitals Group A, B or C (see Appendix C, Table A3 [4]). As a result, New South Wales had 60% of the nation’s public hospitals with ED services, compared with 36% of presentations. Hospitals in the ‘Other hospitals’ category tend to have a greater proportion of non-acute separations compared with the larger acute public hospitals [4]. These variations become particularly evident when viewing the data by small geographic area across Australia. Maps of presentations for Semi-urgent and Non-urgent triage categories show that presentation rates in regional and remote areas in NSW were considerably higher than the national average (see also Table 1). In addition, there is also considerable variation in access within the States and Territories. As a result, while comparisons between capital cities are appropriate, comparisons between areas outside of capital cities between the states and territories should not be made. To assist users in relating variations in rates of presentations to issues of access, the interactive atlases include the locations of 286 hospitals with ED facilities. These facilities were geocoded from the listing reported by the Australian Institute of Health and Welfare [5].

References

  1. Ford G. The role of the Emergency Department as a 'safety net'. Health Issues 2002;73:29-32.
  2. Australian Institute of Health and Welfare (AIHW). Australia's hospitals at a glance 2018-19. Canberra: AIHW; 2020.
  3. Australian Institute of Health and Welfare (AIHW). Australian hospital statistics 2011-12. Health services series no. 50. (Cat. no. HSE 134.) Canberra: AIHW; 2013.
  4. Australian Institute of Health and Welfare (AIHW). Emergency department care 2018–19: Appendices; 2020. https://www.aihw.gov.au/getmedia/8af27189-a1bb-4746-a096-e63d3b8aeac6/Emergency-department-care-201819-Appendixes.pdf.aspx (Accessed 15/06/2021).
  5. Australian Institute of Health and Welfare (AIHW). Emergency department care. Canberra: AIHW; 2021. https://www.aihw.gov.au/reports-data/myhospitals/sectors/emergency-department-care (Accessed 15/06/2021).
 

Confidentiality of data

Counts of less than five presentations have been suppressed.

The Population Health Areas of 30057 Brisbane Inner - North - Central and 30051 Fortitude Valley/Spring Hill have been combined at the request of Queensland Health; data displayed is the combination of values and rates for these areas.

 

Geography: Data available by Population Health Area, Local Government Area, Primary Health Network, Quintile of socioeconomic disadvantage of area and Remoteness Area

 

Numerator:  Presentations to Emergency Departments by Totals, ICD-10-AM Chapter, Triage, and ICD-10-AM Chapter by sex and selected age-group categories (where available).

 

Denominator:  Male, Female and Total populations where applicable.

 

Detail of analysis:  Indirectly age-standardised rate per 100,000 population; and/or indirectly age-standardised ratio, based on the Australian standard.

 

Source:  Compiled by PHIDU using data from the Australian Institute of Health and Welfare, supplied on behalf of State and Territory health departments for 2018/19; and ABS Estimated Resident Population, average of 30 June 2018 and 2019.

 

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