Growth in Western Australian emergency department demand during 2007-2013 is due to people with urgent and complex care needs.
Growth in Western Australian emergency department demand during 2007-2013 is due to people with urgent and complex care needs.
复制标题
2007 年至 2013 年西澳大利亚州急诊室需求的增长是由于人们有紧急和复杂的护理需求。
DOI：
10.1111/1742-6723.12396
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Aboagye-Sarfo P
中科院分区：
文献类型：
--
作者：
Aboagye-Sarfo P
目的确定西澳大利亚州(WA)2007年至2013年ED需求增长的幅度和特征。方法我们进行了一项以人群为基础的纵向研究，按居住地、年龄组、性别、澳大利亚人分类量表类别和出院倾向进行分层。结果衡量的是每年出现ED的次数和比率。我们计算了平均年增长率，以及特定年龄和标准化年龄的增长率。我们使用Mann-Kendall趋势检验和方差分析来评估总体和每个类别内趋势的统计学意义。我们还计算了可归因于人口和使用率变化的ED需求增长的比例。结果从2007年到2013年，ED演示平均每年增长4.6%，从739 742增加到945 244。从每千佤族人口354.1人增加到382.6人，增幅为1.4%(趋势P=0.02)。主要增加发生在大都市西澳，年龄45岁以上，分类2级和3级，以及入院队列。其中约四分之三的增长是由于人口变化(增长和老龄化)，四分之一是由于使用率的增加。结论我们的研究显示，2007-2013年间，西澳的急诊需求每年增加4.6%，主要是因为有紧急和复杂护理需求的人增加，而不是从初级保健转移(需求转移)。这表明，需求管理需要一个全系统的综合办法。
ObjectivesTo determine the magnitude and characteristics of the increase in ED demand in Western Australia (WA) from 2007 to 2013.MethodsWe conducted a population‐based longitudinal study examining trends in ED demand, stratified by area of residence, age group, sex, Australasian Triage Scale category and discharge disposition. The outcome measures were annual number and rate of ED presentations. We calculated average annual growth, and age‐specific and age‐standardised rates. We assessed the statistical significance of trends, overall and within each category, using the Mann–Kendall trend test and analysis of variance ANOVA. We also calculated the proportions of growth in ED demand that were attributable to changes in population and utilisation rate.ResultsFrom 2007 to 2013, ED presentations increased by an average 4.6% annually from 739 742 to 945 244. The rate increased 1.4% from 354.1 to 382.6 per 1000 WA population (P= 0.02 for the trend). The main increase occurred in metropolitan WA, age 45+ years, triage category 2 and 3 and admitted cohorts. Approximately three‐quarters of this increase was due to population change (growth and ageing) and one‐quarter due to increase in utilisation.ConclusionOur study reveals a 4.6% annual increase in ED demand in WA in 2007–2013, mostly because of an increase in people with urgent and complex care needs, and not a shift (demand transfer) from primary care. This indicates that a system‐wide integrated approach is required for demand management.