When chronic conditions become emergencies: a report from regional Queensland

Harriss, Linton R., Thompson, Fintan, Dey, Arindam, Mills, Jane, Watt, Kerrianne, and McDermott, Robyn (2016) When chronic conditions become emergencies: a report from regional Queensland. Australian Journal of Rural Health, 24 (6). pp. 392-401.

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Abstract

Objective: To describe chronic conditions and injuries as a proportion of total emergency presentations to a large public hospital in regional Queensland, and to investigate differences in presentation rates associated with Indigenous status.

Design: Cross-sectional analysis using Emergency Department Information System data between 1 July 2012 and 30 June 2014.

Setting: Regional Queensland, Australia.

Participants: A total of 95 238 emergency presentations were generated by 50 083 local residents living in the 10 statistical local areas (SLAs) immediately around the hospital.

Main outcome measures: Emergency presentations for chronic conditions and injuries identified from discharge ICD-10-AM principal diagnosis. Age-standardised presentation rates were calculated using the Australian 2001 reference population.

Results: Approximately half of all presentations were for chronic conditions (20.2%) and injuries (28.8%). Two-thirds of all chronic condition presentations were for mental and behavioural disorders (34.6%) and circulatory diseases (33.2%). Head injuries accounted for the highest proportion of injuries (18.9%). Age-standardised rates for major diagnostic groups were consistently higher for Indigenous residents, whose presentations were lower in mean age (95% CI) by 7.7 (7.3–8.1) years, 23% less likely to be potentially avoidable GP-type presentations [RR (95% CI) = 0.77 (0.75–0.80)], 30% more likely to arrive by ambulance [1.31 (1.28–1.33)] and 11% more likely to require hospital admission [1.11 (1.08–1.13)].

Conclusions: Opportunities exist to enhance current coordinated hospital avoidance and primary health services in regional Queensland targeting common mental and circulatory disorders, especially for Indigenous Australians.

Item ID: 46156
Item Type: Article (Refereed Research - C1)
Keywords: Aboriginal, Torres Strait Islander, Indigenous, chronic disease, emergency department, health disparity, hospital avoidance
Additional Information:

© 2016 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd. on behalf of National Rural Health Alliance Inc.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

ISSN: 1440-1584
Date Deposited: 24 Oct 2016 00:29
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 100%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920506 Rural Health @ 100%
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