TY - JOUR
T1 - Is the increase in emergency short-stay admissions sustainable? Trends across Melbourne, 2000 to 2009
AU - Lowthian, Judy
AU - Stoelwinder, Johannes Uiltje
AU - McNeil, John James
AU - Cameron, Peter
PY - 2012
Y1 - 2012
N2 - To describe the trends in emergency admissions over 10 years in terms of volume,
age-specific rates, hospital length of stay (LOS) and clinical reasons.
Methods: A retrospective analysis of population-based linked Department of Health ED and hospital
admission data for metropolitan Melbourne 1999/2000 to 2008/2009 was conducted.
Outcome measures included: hospital admission numbers (total, single day/overnight, 2
days LOS); admission rates per 1000 person-years (total, single day/overnight, 2 days
LOS); hospital LOS.
Results: The volume of patients admitted to hospital through EDs rose by 56 over the 10 years
to June 2009. The number of same day/overnight admissions rose by 60 , equating to a
6.1 average annual increase beyond that accounted for by demographic change (95 CI
5.7?6.5 ). The volume of patients admitted for 2 days also increased; however, the
admission rate per 1000 persons for these longer-stay patients declined over the decade by
9 (95 CI 5?12 ). The most frequent discharge diagnoses were injury or poisoning, and
disorders of the circulatory, respiratory or digestive systems. The numbers and mortality
rate for ED admissions declined over the decade.
Conclusion: Emergency hospital admissions have risen over the last decade even after adjustment for
population changes. There was a disproportionate rise in same day/overnight admissions,
with overrepresentation of the elderly. This is possibly related to changes in ED models of
care, including introduction of short-stay units, improved diagnostic and therapeutic capability,
and risk-averse management to optimise safe discharge, within the context of
time-based performance targets.
AB - To describe the trends in emergency admissions over 10 years in terms of volume,
age-specific rates, hospital length of stay (LOS) and clinical reasons.
Methods: A retrospective analysis of population-based linked Department of Health ED and hospital
admission data for metropolitan Melbourne 1999/2000 to 2008/2009 was conducted.
Outcome measures included: hospital admission numbers (total, single day/overnight, 2
days LOS); admission rates per 1000 person-years (total, single day/overnight, 2 days
LOS); hospital LOS.
Results: The volume of patients admitted to hospital through EDs rose by 56 over the 10 years
to June 2009. The number of same day/overnight admissions rose by 60 , equating to a
6.1 average annual increase beyond that accounted for by demographic change (95 CI
5.7?6.5 ). The volume of patients admitted for 2 days also increased; however, the
admission rate per 1000 persons for these longer-stay patients declined over the decade by
9 (95 CI 5?12 ). The most frequent discharge diagnoses were injury or poisoning, and
disorders of the circulatory, respiratory or digestive systems. The numbers and mortality
rate for ED admissions declined over the decade.
Conclusion: Emergency hospital admissions have risen over the last decade even after adjustment for
population changes. There was a disproportionate rise in same day/overnight admissions,
with overrepresentation of the elderly. This is possibly related to changes in ED models of
care, including introduction of short-stay units, improved diagnostic and therapeutic capability,
and risk-averse management to optimise safe discharge, within the context of
time-based performance targets.
UR - http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2012.01609.x/pdf
U2 - 10.1111/j.1742-6723.2012.01609.x
DO - 10.1111/j.1742-6723.2012.01609.x
M3 - Article
SN - 1742-6731
VL - 24
SP - 610
EP - 616
JO - EMA - Emergency Medicine Australasia
JF - EMA - Emergency Medicine Australasia
IS - 6
ER -