Demographic patterns of emergency presentations to Northern Territory public hospitals

Lee, Andy H.; Meuleners, Lynn; Zhao, Yuejen; Intrapanya, Methinee; Palmer, Didier; Mowatt, Elizabeth

doi:10.1071/ah042720061

Cited by 10 publications

(20 citation statements)

References 7 publications

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“…There was a small drop in the reported proportion of presentations to NT EDs by Indigenous patients from 47% in 1996-2001 16 to 41% in this study. Consequently, the ratio of NT Indigenous to non-Indigenous use of EDs fell from 2.1 to 1.7.…”

Section: Discussioncontrasting

confidence: 62%

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Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people

Thomas¹,

Anderson²,

Kelaher³

2008

Aust. Health Review

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Objectives: To examine the accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people compared with other Australians. Methods:We examined 2004-05 data from the National Non-admitted Patient Emergency Department Care database from the Northern Territory and Western Australia, the only jurisdictions where Indigenous identification in the database was considered acceptable. Results:In the NT, Indigenous people were 1.7 times as likely to present to an emergency department as non-Indigenous people. Indigenous patients in the NT and WA do not appear to use EDs for "primary care" problems more than nonIndigenous patients. More NT Indigenous patients walked out before being seen or before their treatment was completed. However, Indigenous patients generally waited a similar time, and often slightly shorter, to be seen as similar non-Indigenous patients in WA and the NT. Conclusions:We recommend the regular monitoring of equity in the accessibility and quality of ED care for Indigenous people compared with other Australians. Indigenous identification in the database needs to improve so monitoring of ED However, most Aboriginal and Torres Strait Islander health care policy and research has concentrated on the primary care rather than the hospital sector.2 Most of the limited attention to hospital services has been on admitted patients rather than emergency departments (EDs), the focus of this paper.The Aboriginal and Torres Strait Islander Health Performance Framework 3 reported that Indigenous Australians were twice as likely to have visited an ED or outpatients clinic in the last week as other Australians. In contrast, the same national surveys showed that Indigenous Australians were only 1.1 times as likely as other Australians to have used any health care services. It is not apparent from these results whether Indigenous patients were accessing ED services at appropriately higher rates than other Australians because of their greater morbidity or What is known about the topic? Indigenous people attend emergency departments (EDs) more often than other Australians, wait a similar length of time before being seen, but are more likely to leave before receiving treatment. What does this paper add?The study confirmed what was known, and found that Indigenous patients in the Northern Territory and Western Australia did not appear to use EDs for "primary care" problems more than non-Indigenous patients. What are the implications for practitioners?The study suggests that EDs may be performing more equitably for Indigenous people than other elements of the health system, but Indigenous identification in the database needs to improve so that monitoring of ED performance can extend beyond WA and the NT.

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Section: Discussioncontrasting

confidence: 62%

“…The Indigenous population and Indigenous ED patients are younger than the corresponding non-Indigenous population and patients. 15,16 As age is variously associated with the indicators we measured, age-standardised comparisons may have differed from those reported here.…”

Section: Discussionmentioning

confidence: 74%

Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people

Thomas¹,

Anderson²,

Kelaher³

2008

Aust. Health Review

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Section: Emergency Department Studiesmentioning

confidence: 99%

“…Lee et al (2004) conducted a retrospective analysis of the emergency department attendances at five Northern Territory hospitals from 1996 to 2001. The rate of presentation was higher for Aboriginal and Torres Strait Islander people in every age group except the 5-9, 10-14, 15-19 and 70-74 age groups (Lee et al 2004). Moshin (2002) analysed the emergency department presentations at metropolitan and rural NSW hospitals and found the presentation rates were significantly higher for rural Aboriginal and Torres Strait Islander people (3.9%) than for metropolitan Aboriginal and Torres Strait Islander people (0.8%) (Moshin 2002).…”

Section: Emergency Department Studiesmentioning

confidence: 99%

Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People

Costa

Sullivan

Walker

et al. 2008

HIM J

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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.

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“…These ambulatory care–sensitive conditions (ACSCs) are conditions for which management is influenced by primary care access, care funding, and the patient’s socioeconomic status, as well as the medical condition itself [4]. More vulnerable groups within the community, such as elderly patients [5], Aboriginal and Torres Strait Islanders [6], and patients of low health literacy [7], are considered more likely to present for emergency care. Both incentivizing care in order to lower direct primary care costs to patients and improving the management of such conditions in primary care may affect hospital admissions for those conditions [8].…”

Section: Introductionmentioning

confidence: 99%

Using Patient Flow Information to Determine Risk of Hospital Presentation: Protocol for a Proof-of-Concept Study

Pearce¹,

McLeod²,

Patrick³

et al. 2016

JMIR Res Protoc

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BackgroundEvery day, patients are admitted to the hospital with conditions that could have been effectively managed in the primary care sector. These admissions are expensive and in many cases are possible to avoid if early intervention occurs. General practitioners are in the best position to identify those at risk of imminent hospital presentation and admission; however, it is not always possible for all the factors to be considered. A lack of shared information contributes significantly to the challenge of understanding a patient’s full medical history. Some health care systems around the world use algorithms to analyze patient data in order to predict events such as emergency presentation; however, those responsible for the design and use of such systems readily admit that the algorithms can only be used to assess the populations used to design the algorithm in the first place. The United Kingdom health care system has contributed data toward algorithm development, which is possible through the unified health care system in place there. The lack of unified patient records in Australia has made building an algorithm for local use a significant challenge.ObjectiveOur objective is to use linked patient records to track patient flow through primary and secondary health care in order to develop a tool that can be applied in real time at the general practice level. This algorithm will allow the generation of reports for general practitioners that indicate the relative risk of patients presenting to an emergency department.MethodsA previously designed tool was used to deidentify the general practice and hospital records of approximately 100,000 patients. Records were pooled for patients who had attended emergency departments within the Eastern Health Network of hospitals and general practices within the Eastern Health Network catchment. The next phase will involve development of a model using a predictive analytic machine learning algorithm. The model will be developed iteratively, testing the combination of variables that will provide the best predictive model.ResultsRecords of approximately 97,000 patients who have attended both a general practice and an emergency department have been identified within the database. These records are currently being used to develop the predictive model.ConclusionsRecords from general practice and emergency department visits have been identified and pooled for development of the algorithm. The next phase in the project will see validation and live testing of the algorithm in a practice setting. The algorithm will underpin a clinical decision support tool for general practitioners which will be tested for face validity in this initial study into its efficacy.

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Demographic patterns of emergency presentations to Northern Territory public hospitals

Abstract: This study investigates demographic patterns of emergency presentations to Northern Territory (NT)

Cited by 10 publications

References 7 publications

Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people

Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people

Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People

Using Patient Flow Information to Determine Risk of Hospital Presentation: Protocol for a Proof-of-Concept Study

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