New data reveals lower urgency ED visit prevalence

A large percentage of emergency department presentations could be managed more appropriately by community health services such as pharmacists

More than one-third of presentations to hospital emergency departments (EDs) are for lower urgency care, some of which may be managed more appropriately by health services in the community, says the Australian Institute of Health and Welfare (AIHW).

In 2018-19, around one in three ED presentations (35% or 2.9 million) were classified as lower urgency, according to new data released by AIHW on Thursday. This rate has remained relatively stable since 2015−16.

Lower urgency ED presentations are those where the person was assessed as needing semi-urgent or non-urgent care; did not arrive by ambulance, or police or correctional vehicle; was not admitted to the hospital; was not referred to another hospital; and did not die.

Just under half (47%) of all lower urgency ED presentations occurred during a period when general practices and other alternate health services are usually closed—for example, on Sundays, public holidays, and weekdays before 8am and after 8pm.

Meanwhile people in regional PHN areas continue to receive lower urgency ED care more than people in metropolitan PHN areas.

There were 164 presentations per 1,000 people in regional areas in 2018−19, compared to  90 per 1,000 people in their metropolitan counterparts.

The 2018–19 ABS Patient Experience Survey found that 16.8% of respondents aged 15 and over who visited an ED for any reason (representing an estimated 461,500 people) thought their care could have been provided by a GP for their most recent visit to the ED.

One in 5 (21%) reported that the main reason was because a GP was not available when required.

“ED presentations that are lower urgency are sometimes used as a proxy measure of access to primary health care,” says AIHW in its report.

“Higher presentation rates may suggest a lack of access to GPs or other primary health services, which may have been better placed to manage a person’s health condition.”

Victorian branch president of the Pharmacy Guild, Anthony Tassone, says community pharmacists are uniquely placed to relieve some of the strain on “already overworked” GPs and overcrowded emergency departments, particularly in regional areas of Australia and during the COVID pandemic.

“Pharmacists are already the most easily accessible and most frequently visited health professionals in the country, so it makes sense to better use resources already in the health system,” says Mr Tassone.

“It is within the existing scope of training and practice for pharmacists to do more, and it is high time Australian patients and the health system benefitted from getting full value from trained health professionals at local pharmacies across the country.

“By empowering pharmacists to treat common ailments, administer more vaccinations and provide repeat prescriptions for stable and ongoing conditions, we can overcome some of the problems caused by the growing shortage of GPs and pressure of EDs, particularly in rural and regional areas.”

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