Emergency department presentations increase

The RACGP’s Vision for general practice and a sustainable healthcare system (the Vision), is clear in its conclusion: billions could be saved if more people attended general practice instead of a hospital emergency department.
 
‘Better support and investment in general practice will reduce the prevalence of low-urgency emergency presentations and preventable hospital admissions, and could achieve a total annual saving of up to $4.5 billion,’ the Vision states.
 
‘Governments pay more for a single-patient hospital admission than the cost of that same patient visiting their GP twice a week for an entire year.
 
‘GPs and their teams already provide preventive care to their patients. However, there is opportunity for patients to be further supported to access preventive care routinely through their general practice.’
 
According to a new Australian Institute of Health and Welfare (AIHW) report, the 8.4 million emergency department presentations in 2018–19 represented a 4.2% increase on the previous year. Over the same 12-month period, there were close to four million non-urgent or semi-urgent emergency department presentations across Australia that could have been handled in a primary care setting.
 
Overall, 70% of emergency department visits were completed within four hours in 2018–19, down from 73% in 2014–15.
 
Additionally, 90% of emergency department visits were completed within seven hours and 29 minutes in 2018–19, a 15-minute increase compared to 2017–18.
 
The RACGP’s Vision outlines a model of care that aims to address longstanding healthcare challenges, in particular the under-resourcing of general practice and subsequent increased pressure on the secondary health sector from avoidable emergency department presentations.
 
AIHW spokesperson Dr Adrian Webster said that while all patients in the most urgent category, ‘Resuscitation’, were seen immediately, only 71% of patients were seen on time for their urgency category in 2018–19, down from 74% in 2014–15.
 
‘The proportion of emergency department patients seen on time ranged from 46% in the Australian Capital Territory to 78% in New South Wales,’ he said.
 
‘Almost three in four [74%] Indigenous [Australian] emergency department patients were seen on time, compared to 71% of other patients.’
 
Western Australia recorded an 11.5% increase in emergency department presentations over the 12-month period, nearly three times greater than the national average. The Northern Territory had the highest number of presentations per 1000 people – 689.9 – with Western Australia the next closest state or territory with 365.9.
 
Major cities only reported 19 non-urgent presentations per 1000 people, compared to more than 100 per 1000 residents in remote and very remote areas.
 
The majority of emergency department patients (60%) went home after being treated, while nearly half (48%) were not assigned to the three most urgent triage categories. Residents based in the lowest socioeconomic areas were also more likely to present at EDs compared to those in the highest areas.
 
More than 500,000 patients did not wait or left emergency department at their own risk, including more than 20,000 patients triaged in the two most urgent categories.
 
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AIHW emergency department hospitals RACGP Vision