Access block in Australian emergency departments 2017-2020

Area of Science:

• Emergency Medicine
• Public Health
• Health Services Research

Background:

• Australian emergency departments (EDs) face increasing workloads.
• Understanding trends in ED demand and occupancy is crucial for resource allocation.
• The impact of the COVID-19 pandemic on healthcare systems requires urgent investigation.

Purpose of the Study:

• To analyze Australian ED workload trends between 2017 and 2020.
• To assess the influence of the COVID-19 pandemic on ED demand and occupancy.
• To identify factors influencing ED performance during the pandemic.

Main Methods:

• Retrospective analysis of voluntary survey data from Australasian College for Emergency Medicine accredited EDs (2017-2020).
• Data collected twice annually (June and September) included demand and occupancy metrics.
• Hospitals were categorized by jurisdiction and role delineation for comparative analysis.

Main Results:

• Between June 2017 and 2019, ED presentations increased by 11.4%, with a 27.7% rise in treatment times and a 46.1% increase in access block.
• From June 2019 to 2020, ED presentations decreased by 12.6%, while ward admissions remained stable.
• Patients leaving without being seen fell by 57.8% in 2020, with Major Paediatric Referral hospitals reporting a 28% decrease in presentations.

Conclusions:

• ED occupancy rose disproportionately to demand from 2017-2019.
• The COVID-19 pandemic led to a notable decrease in ED presentations in 2020.
• Future research should explore geographical, hospital role, and practice variations in pandemic response within EDs.