Demographic patterns of emergency presentations to Northern Territory public hospitals.

This study investigates demographic patterns of emergency presentations to Northern Territory (NT) public hospitals over the past five years with respect to population changes, Aboriginality and age of patients. Retrospective analysis was undertaken on the 1996-2001 data extracted from the NT Module of Caresys and the Hospital Morbidity Data System. There was a 4.6% decrease in total presentations to the five public hospitals but a 9.4% growth in the population during the study period. Substantial differences in emergency presentation patterns were found between Aboriginal and non-Aboriginal patients. There were more Aboriginal presentations than non-Aboriginal presentations for all age groups except for 5 to 19 years and 70 to 74 years. Analysis based on the national triage scale showed the higher needs of older adults with the 60 or over age group accounting for the majority of presentations, and Aboriginal presentation rates exceeded the non-Aboriginal presentation rates in most triage categories. Re-attendance within seven days at the emergency departments occurred predominantly among Aboriginal patients regardless of age group. The analysis has highlighted several emerging demographic patterns. The issue of non-urgent visits by Aboriginal patients occupying a large portion of the emergency department utilisation also needs to be addressed.

The changing role of the emergency department in the Northern Territory: a Delphi study.

OBJECTIVE: To explore the changing role of EDs in Northern Territory hospitals. METHODS: A two-round Delphi study was undertaken by recruiting a panel of health professionals from the EDs of the five Northern Territory public hospitals. Participants in round one were asked to list changes they have encountered and how these changes have affected health service delivery, as well as five factors that were responsible for the changes. During the second round they prioritized the factors identified in order of importance. RESULTS: Twenty-four ED staff returned their questionnaire. Global changes identified were more verbal/physical abuse from patients, followed by increase in acuity of patient presentations. The most important factor perceived as responsible for the changes was budget cuts, resulting in fewer inpatient beds, an increase in access block and sicker patients being discharged too early. CONCLUSION: The Delphi evaluation provided insights into the problems facing the ED from the staff perspective and offered some suggestions to deal with the emerging issues.

Emergency presentations to Northern Territory public hospitals: demand and access analysis.

This study aims to quantify trends in emergency presentations to Northern Territory (NT) public hospitals over the past five years with respect to demand and access. Retrospective analysis was undertaken on data extracted from the NT Module of Caresys and the Hospital Morbidity Data System. There has been a 4.6% decrease in presentations to the five public hospitals between 1996 and 2001 compared to a 9.4% growth in the population. Despite the apparent decline in total presentations, the acuity of patients has increased dramatically over the same period. Access analysis of presentations seen within the recommended triage time revealed considerable variability, especially for triage categories 2, 3 and 4. The access block problem, discrepancies in recorded waiting time and irregularities among the regional hospitals within the triage system have also been identified. Recommendations including improved access to inpatient beds and admission to wards were developed in response to the changing role of the emergency department.