Time Trends in the Rates of ED Visits in Australia, an Age-Period-Cohort Approach

Assess the effects of Age, Period and Cohort (APC) in the trends in emergency department (ED) visits in 2003-2023 in Australia.

For this retrospective observational study, we obtained data on all ED visits in Australia in 2003-2023 from the Australian Institute of Health and Welfare and applied an APC model to separate Age, Period and Cohort effects.

The total number of ED visits increased from 4,306,183 in 2003 to 7,194,861 in 2013 (67% increase). A 25% increase was observed in 2013-2023 (n = 9,014,526 visits in 2023). Rates of ED visits have increased in Australia in 2003-2023 from 218 per 1000 residents to 338 per 1000. Rates of ED visits were higher in patients aged > 85 years and have increased in 2003-2023 from 525 per 1000 to 835 per 1000 (59% increase). The increase in the number of ED visits per capita was slightly lower in those aged 65-74 (from 226 per 1000 in 2003 to 338 per 1000 in 2023, 50% increase) and those aged 75-84 years (350 per 1000 to 526 per 1000, 50% increase) compared to residents aged > 85 years.

Our APC modelling shows a deceleration in the increase in the rate of ED visits in the last decade, despite at the same age younger generations having higher rates of ED visits than older generations. The consistent increase in ED visits per capita in those aged < 75 years has major implications for healthcare planning and policies needed to reduce ED demand.