Trends and characteristics of short-term and frequent representations to emergency departments: A population-based study from New South Wales, Australia

ObjectiveThe objective of this study is to describe the trends and characteristics of short-term and frequent representations to EDs in New South Wales, Australia. MethodsThis was a retrospective analysis of a linked population-based registry of ED representations in New South Wales, conducted as part of the Demand for Emergency Services in Years 2010-2014 project. Trend analysis of unplanned representations to ED within 3days of discharge from ED, readmission to an in-patient unit within 30days of index in-patient admission from ED and demographic data and trends for frequent and very frequent ED presenters is discussed. ResultsA total of 10798797 ED presentations were identified from 4188283 individual patients. Within 1year, 48.9% of ED presentations had a previous presentation, and 4.9% had represented within 3days of a previous presentation. The readmission rate within 30days was 2.8%, the proportion of frequent (representing 5212 [0.1%] individual patients) and very frequent representations (representing 1186 [0.03%] individual patients) were 1.7% and 1.0%, respectively. The overall rate of representations within 3days has decreased from 5.1% in 2010 to 4.7% in 2014 (P<0.001). The rate of readmissions within 30days has increased from 2.4% in 2010 to 3.1% in 2014 (P<0.001). ConclusionsIn this population-based study, short-term representations were highest in the infant patient population, in-patient readmission rates were highest in the elderly and very frequent representations to ED were characterised by middle-aged patients with mental health or drug and alcohol related presentations.