Planning for the future: Emergency department presentation patterns in Tasmania, Australia

Abstract

Background: Emergency department crowding and associated adverse outcomes are major issues in health care systems worldwide. The Australian government has highlighted the need to analyse emergency presentations to inform system redesign.

Objective: To describe the profile of emergency department presentations by Tasmanian residents to emergency departments over four years, and examine regional variations.

Method: A retrospective analysis of emergency department data for Tasmania's public hospitals over four financial years, 2010-11 to 2013-14, was undertaken. Descriptive statistics were used to identify patterns in Tasmanian state-wide emergency presentations, as well as disparities between Tasmania's three regions (South, North and North-West). Regression analysis was undertaken to test if changes were significant.

Results: State-wide presentations increased by 3.4% (139,352-144,130) over the four years. Regional variations included an increase in presentations of 16% in the South, 5.1% in the North and a decrease of 3.9% in the North-West. Per capita presentations were consistently lowest in the South and highest in the North-West. The South recorded a significant increase in per capita presentations of those aged 75 and over (p=0.001), increasing at a rate of 12.5 per 1000 residents per annum (95% CI 5.8-19.2).

Conclusion: There is regional variation in emergency demand and utilisation in Tasmania. The results indicate that recent increases are predominantly occurring in the South, including in the elderly, and the reasons for this warrant further investigation.

Keywords: Crowding; Decision making; Demand; Emergency services, hospital; Health-seeking behaviour.