Notes on the data: Emergency department presentations

Variation in the provision of Emergency Department services by capital city and rest of state/territory

The extent of variation in the provision of ED services counted in this collection is shown in Table 1, where the age-standardised rate of presentations for Australia has been set as 100, and the rates in the capital cities and Rest of State/ NT areas (the areas outside of the capital cities) are shown as an index number relative to the Australian rate.

Some highlights from the table are noted below.

For capital cities:

• the range for Total presentations is from 26% below the national rate in Hobart and 20% below in Melbourne to 23% above in Darwin and 10% above in Canberra;
• for Urgent presentations, the range is from 30% below in Hobart to 20% above in Brisbane and Canberra;
• for Semi-urgent presentations, the range is from 26% below in Hobart and 24% below in Brisbane to 32% above in Darwin; and
• for Non-urgent presentations, from 49% below in Brisbane and 44% below in Perth, to 11% above in Canberra and 8% above in Hobart.

For Rest of states/ NT:

• the range for Total presentations is from 16% below the national rate in Rest of SA to 293% above in Rest of NT;
• for Urgent presentations, the range is from 32% below the national rate in Rest of SA to 256% above in Rest of NT;
• for Semi-urgent presentations, the range is from 20% below in Rest of Qld to 307% above in Rest of NT; and
• for Non-urgent presentations, from 52% below in Rest of Qld, to 351% above in Rest of NT and 307% above in Rest of NSW.

Table 1: Variations in age-standardised rates, expressed as an index, of Emergency Department presentations, 2017/18 (Australia = 100).

Section of States/ NT	Total	Urgent	Semi-urgent	Non-urgent
Australia	100	100	100	100
All capital cities	89	94	86	67
Sydney	88	88	86	80
Melbourne	80	85	81	64
Brisbane	97	120	76	51
Adelaide	94	97	85	60
Perth	96	91	105	56
Hobart	74	70	74	108
Darwin	123	109	132	59
Canberra	110	120	109	111
Rest of NSW	159	126	176	307
Rest of Vic	99	92	107	116
Rest of Qld	92	110	80	48
Rest of SA	84	68	102	118
Rest of WA	127	108	146	162
Rest of Tas	118	111	140	124
Rest of NT	293	256	307	351

 

Emergency Department presentations by Chapter and Triage category

The dataset was split by ICD-10-AM Chapter and triage category (Table 2) to create 60 indicators of different type and severity. The ICD-10-AM chapter is categorised from the ICD-10 codes as reported in each patient's principal diagnosis. The triage category is assigned to a patient by the ED to indicate the urgency of the patient’s need for medical and nursing care.

Table 2 shows the distribution and number of records used to create the atlases by ICD-10-AM Chapter and triage categories. To achieve the numbers required to present information without a large degree of confidentilisation, the Resuscitation and Emergency triage categories were aggregated for 6 chapters where presentations for Resuscitation were less than 3,000. These were for chapters: Certain infectious and parasitic diseases, Mental and behavioural disorders, Diseases of the digestive system, Diseases of the musculoskeletal system and connective tissue, Diseases of the genitourinary system and Factors influencing health status and contact with health services.

Table 2: Emergency Department presentations by ICD-10-AM Chapter and Triage category for 2017/2018

ICD-10-AM Chapter	Resuscitation: Immediate (within seconds)	Emergency (within 10 minutes)	Resuscitation and Emergency (within 10 minutes)	Urgent (Within 30 minutes)	Semi-Urgent (Within 60 minutes)	Non-urgent (within 120 minutes)	Total
Certain infectious and parasitic diseases	-	-	35,127	169,520	178,784	16,732	400,163
Mental and behavioural disorders	-	-	41,644	134,744	79,808	16,305	272,501
Diseases of the circulatory system	13,777	144,860	-	126,893	45,598	5,952	337,080
Diseases of the respiratory system	7,726	124,709	-	290,715	180,159	16,874	620,183
Diseases of the digestive system	-	-	36,748	209,759	159,549	16,335	422,391
Diseases of the musculoskeletal system and connective tissue	-	-	17,328	103,614	205,947	39,610	366,499
Diseases of the genitourinary system	-	-	35,122	152,904	114,566	10,995	313,587
Injury, poisoning and certain other consequences of external causes	14,995	152,909	-	515,714	1,007,183	246,512	1,937,313
Factors influencing health status and contact with health services	-	-	23,662	85,804	150,285	130,521	390,272
Other	13,703	409,736	-	1,080,037	861,781	144,264	2,509,521
Total	57,648	1,014,398	n.a.	2,869,704	2,983,660	644,100	7,569,510

 

n.a. – not applicable, resuscitation and emergency totals recorded in their corresponding triage category totals.

Detailed information on the Emergency Department dataset

The data include presentations to EDs between 1 July 2017 and 30 June 2018. The data presented are sourced from the AIHW’s National Non-admitted Patient Emergency Department Care Database (NNAPEDCD), which is based on the Non-admitted Patient Emergency Department Care (NAPEDC) National Minimum Data Set/National Best Endeavours Data Set (NMDS/NBEDS). The NNAPEDCD provides information on the care provided for non-admitted patients registered for care in EDs in public hospitals where the ED meets the following criteria:

• a purposely designed and equipped area with designated assessment, treatment, and resuscitation areas
• the ability to provide resuscitation, stabilisation, and initial management of all emergencies
• availability of medical staff in the hospital 24 hours a day
• designated emergency department nursing staff 24 hours per day 7 days per week, and a designated emergency department nursing unit manager.

Emergency departments (including ‘accident and emergency’ or ‘urgent care centres’) that do not meet the criteria above are not in scope for the NMDS, but data may have been provided for some of these by some states and territories [1].

The coverage of the NNAPEDCD was considered complete for public hospitals which meet the above criteria. The collection does not include all emergency services provided in Australia; for example, emergency service activity provided by private hospitals, or by public hospitals which do not have an ED that meets the above criteria are excluded. This should be taken into account, particularly when comparing data between urban and regional areas, or by Remoteness Area. States and territories provided Emergency Department diagnosis information in several classifications, including SNOMED CT-AU, International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM); and various editions of ICD-10-AM. For the purpose of reporting principal diagnoses, the AIHW mapped the provided information to ICD-10-AM 10th edition codes, where necessary.

Chapter ICD-10-AM definitions

Any of the reported principal diagnosis as per the below:

1. A00–B99 (Certain infectious and parasitic diseases)
2. F00–F99 (Mental and behavioural disorders)
3. I00–I99 (Diseases of the circulatory system)
4. J00–J99 (Diseases of the respiratory system)
5. K00–K93 (Diseases of the digestive system)
6. M00–M99 (Diseases of the musculoskeletal system and connective tissue)
7. N00–N99 (Diseases of the genitourinary system)
8. S00–T98 (Injury, poisoning and certain other consequences of external causes)
9. Z00–Z99 (Factors influencing health status and contact with health services).
10. C00–D48, D50–D89, E00–E90, G00–G99, H00–H59, H60–H95, L00–L99, O00–O99, P00–P96, Q00–Q99, R00–R99, U50–Y98 (Other).