Emergency Department Presentations Are Increasing in Acuity in the State of Victoria, Australia—Statewide Hierarchical Regression Model for 2018–2024

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia Pub Date : 2025-08-04 DOI:10.1111/1742-6723.70113

Andy Lim

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Abstract

Background

Emergency departments are seeing an ever-increasing number of patients each year due to various gaps in health services. The aim is to measure significant trends in patient numbers and acuity, considering statewide investment in diversion strategies.

Methods

A multilevel analysis to test for trend over time in emergency department presentations to public hospital emergency departments from 1st July 2018 to 31st June 2024, taking into account clustering of observations by triage category and by health service, and correcting for population growth. Data were extracted from the Australian Institute of Health and Welfare and Australian Bureau of Statistics.

Results

A total of 11,090,840 emergency presentations were reported by 31 health services. Compound annual growth rate calculation noted a rise in category one (8.6%), two (6.8%) and three (2.9%) presentations, and a corresponding reduction in category four (−3.1%) and five (−5.3%) presentations per year over the five-year period. Total presentations increased by 0.7%, while the state population increased by 1.2% per year over the same period. Multilevel modelling correcting for population growth noted a decrease in category four presentations (−2.4%, 95% CI −3.9, −1.0, p < 0.001) and an increase in category three (4.0%, 95% CI 2.4, 5.6, p < 0.001) and category two (10.2%, 95% CI 4.9, 15.5, p < 0.001) presentations. There was no statistically significant growth in overall numbers (1.4%, 95% CI −3.2, 6, p = 0.552).

Conclusion

Emergency department presentations appear to be increasing in acuity in the state of Victoria, Australia. This rising urgency should prompt the health system to anticipate and prepare accordingly.

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澳大利亚维多利亚州急诊科报告的敏锐度正在增加——2018-2024年全州层次回归模型

背景：由于卫生服务方面的各种差距，急诊部门每年接待的病人数量不断增加。其目的是衡量患者数量和敏锐度的显著趋势，考虑到全州范围内对转移战略的投资。方法采用多水平分析，检验2018年7月1日至2024年6月31日公立医院急诊科急诊科就诊人数随时间的趋势，同时考虑按分类分类和按卫生服务分类的聚类观察结果，并校正人口增长。数据摘自澳大利亚卫生和福利研究所和澳大利亚统计局。结果31家卫生服务机构共报告急诊11,090,840例。复合年增长率计算表明，在五年期间，第一类（8.6%）、第二类（6.8%）和第三类（2.9%）申报量有所增加，而第四类（- 3.1%）和第五类（- 5.3%）申报量相应减少。在同一时期，总演讲量增加了0.7%，而该州人口每年增长1.2%。对人口增长进行校正的多层次模型指出，第四类呈现减少（- 2.4%,95% CI - 3.9, - 1.0, p < 0.001），而第三类呈现增加（4.0%,95% CI 2.4, 5.6, p < 0.001）和第二类呈现增加（10.2%,95% CI 4.9, 15.5, p < 0.001）。总体人数没有统计学上的显著增长（1.4%,95% CI - 3.2, 6, p = 0.552）。结论在澳大利亚维多利亚州，急诊科的报告似乎在增加。这种日益紧迫的情况应促使卫生系统作出相应的预测和准备。

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.