Deck the halls with rows of trolleys...emergency departments are busiest over the Christmas holiday period

Abstract

Objectives: To assess changes in emergency department (ED) activity and visits to EDs that could have been managed by general practitioners (GP-type visits) in the Christmas and New Year holiday period compared with the rest of the year.

Design and setting: Retrospective descriptive and analytical comparison of New South Wales ED visits in the holiday period and the rest of the year; data were obtained from the NSW Emergency Department Data Collection database for the period 2001 to early 2006. More detailed information in 2005-2006 allowed GP-type visits to be assessed in this period only.

Main outcome measures: The change in the number and percentage of weekly ED visits during the holiday period.

Results: Between 2001 and 2006, average weekly counts of ED visits increased by 9% (95% CI, 7%-11%) during the holiday period. The holiday increase was largely accounted for by visits that were less urgent, and for patients who were not admitted, did not arrive by ambulance, had a shorter treatment time and arrived between 08:00 and midnight. In 2005-2006, average weekly counts of GP-type visits increased by 21% (95% CI, 15%-28%) compared with 8% (95% CI, 4%-12%) for ED visits overall. However, GP-type visits accounted for only 39% of the additional holiday visits. GP-type visits increased mainly for adults and more in urban than rural areas.

Conclusions: The Christmas and New Year period is the busiest time of year for NSW EDs. However, only some of the additional holiday visits can be attributed to GP-type visits. Improving access to GPs, but also to broader hospital and community-based health care services over the holiday period, should be considered for managing the excess demand.