Geospatial mapping of emergency department presentations in New South Wales Australia (2015 and 2021): Trends in rural and metropolitan areas—A data linkage study

Abstract

Objectives

To examine the relationship between the frequency of presentations to EDs among metropolitan, regional and rural areas in New South Wales (NSW).

Methods

Retrospective geospatial data linkage cohort study; analysis of total ED presentation rates based on statistical area level 2 (SA2), a standardised geographic unit defined by the Australian Bureau of Statistics (ABS) to represent populations that interact socio-economically. The participants were patients presenting to NSW hospital EDs in 2015 and 2021, based on all hospitals included in the NSW ED Data Collection (EDDC). The main outcomes measured were the relationships at the SA2 level between total ED presentation rates (counting all presentations), total number of different patients who presented at least once per calendar year, and the ratio of total presenters to unique individual presenters (as a marker of repeated presentations).

Results

Total presentations to ED per 10 000 population in metropolitan areas decreased by 0.4% (12/2813). In inner regional Australia, there was instead a 10.6% (535/5051) increase. In outer regional Australia, there was a 20.7% (1189/5747) increase. In remote Australia and very remote Australia, ED presentations per 10 000 population increased by 94.6% (5989/6331). Changes were consistent geospatially, demonstrating large increases in presentations in rural and regional areas, but almost no change in metropolitan areas.

Conclusions

There was an increase in total ED presentation rates in regional and remote areas between 2015 and 2021, while metropolitan areas saw a slight decrease in presentation rates. Further analysis should be conducted to determine the cause of this increase.