Description of the activity of selected hospital emergency departments in New Zealand Report Eight

A description of the activity of selected hospital emergency departments in New Zealand
The National Primary Medical Care Survey (NatMedCa): 2001/02 Report 8

Date of publication: July 2005

ISBN 0-478-29636-3 (Book)
ISBN 0-478-29637-1 (Internet)
HP 4145

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Citation: Raymont A, von Randow M, Patrick D, Lay-Yee R, Davis P. 2005. A Description of the Activity of Selected Hospital Emergency Departments in New Zealand: The National Primary Medical Care Survey (NatMedCa): 2001/02 Report 8. Wellington: Ministry of Health.

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The views expressed in this occasional paper are the personal views of the authors and should not be taken to represent the views or policy of the Ministry of Health or the Government. Although all reasonable steps have been taken to ensure the accuracy of the information, no responsibility is accepted for the reliance by any person on any information contained in this occasional paper, nor for any error in or omission from the occasional paper.

A description of the activity of selected hospital emergency departments in New Zealand

As part of the NatMedCa survey data, was collected from 4 Emergency Departments (EDs) using the data systems in these. Data on all patients’ visits during four periods of one week each over one year was collected. A total of 15,655 patient visits were recorded in this time.

The overall mean age of patients presenting was 32. Sixty percent were European, 12.5% Māori, 10.5% Pacific and 18% other ethnic groups. Forty five percent of attendees came from Deciles 8 – 10. Patients reported attending an average of 2.2 times in the previous year. The busiest days were the weekends and Monday.

Seven point five percent were in triage categories 1 and 2 (urgent) while 51.8 percent were in categories 4 and 5 (less urgent). Injury/Poisoning and respiratory categories were the most common reasons for presenting. The most common action/treatment coded was investigation, examinations and screening. The mean overall ward admission rate was 40.5%, varying from 25.3% to 49.8% between departments.

Comparisons were made between the populations of the 4 EDs. Overall the age, socio-economic status and ethnicity of the patients seen in each ED matched the population of the area. Rates of ED usage appear to be lower where the population is more geographically dispersed. One ED had a higher rate of use with more injuries and a younger than expected age mix. This appeared to be related to the fact that the ED was in an area with a large local student population.

Some comparisons between the nature of presentation in EDs, general practices and Accident and Medical Clinics are made. The average age of presenters in EDs is lower than that in general practices, but higher than that in A&M clinics. Injury was the most common reason for presenting in both EDs and A&M centres while respiratory reasons for presenting were commoner in general practices.

The researchers reported substantial difficulties in comparing data across EDs and between EDs and A&M clinics and general practices. They believe that adopting standardised reporting systems would reduce this difficult and improve the nature of reporting from EDs.

One of the aims of the PHCS is lower barriers to community based primary health care. The authors suggested that a reduction in the rates of people attending EDs with respiratory conditions might be an indicator that this goal was being achieved.

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