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Socioeconomic disadvantage as a driver of non-urgent emergency department presentations: A retrospective data analysis


Unwin, M and Crisp, E and Stankovich, J and McCann, D and Kinsman, L, Socioeconomic disadvantage as a driver of non-urgent emergency department presentations: A retrospective data analysis, PloS One, 15, (4) Article e0231429. ISSN 1932-6203 (2020) [Refereed Article]


Copyright Statement

Copyright 2020 Unwin et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1371/journal.pone.0231429


Background: Globally, emergency departments (EDs) are struggling to meet the service demands of their local communities. Across Australia, EDs routinely collect data for every presentation which is used to determine the ability of EDs to meet key performance indicators. This data can also be used to provide an overall picture of service demand and has been used by healthcare planners to identify local needs and inform service provision, thus, using ED presentations as a microcosm of the communities they serve. The aim of this study was to use ED presentation data to identify who, when and why people accessed a regional Australian ED with non-urgent conditions.

Method and materials: A retrospective data analysis of routinely collected ED data was undertaken. This included data obtained over a seven-year period (July 2009 to June 2016) in comparison with the Australian Bureau of Statistics census data. Analysis included descriptive statistics to identify the profile of non-urgent attendees and linear regression to identify trends in ED usage.

Results: This study revealed a consistently high demand for ED services by people with non-urgent conditions (54.1% of all presentations). People living in the most disadvantaged socioeconomic decile contributed to 36.8% of these non-urgent presentations while those under 25 years of age contributed to 41.1%. Diagnoses of mental health and behavioural issues and of non-specific symptoms significantly increased over the study period (p < 0.001) for both diagnostic groups.

Conclusion: The over-representation by those from the most socioeconomically disadvantaged areas highlights an inequity in access to services. The over-representation by those younger in age indicates behavioural patterns based on age. These key issues faced by our local community and the disparity in current service provision will be used to inform future health policy and service planning.

Item Details

Item Type:Refereed Article
Keywords:hospital services, emergency department, non-urgent presentation, socioeconomic aspects of health, mental health and psychiatry
Research Division:Health Sciences
Research Group:Nursing
Research Field:Acute care
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Unwin, M (Ms Maria Unwin)
UTAS Author:Crisp, E (Dr Elaine Crisp)
UTAS Author:Stankovich, J (Dr Jim Stankovich)
UTAS Author:McCann, D (Ms Damhnat McCann)
UTAS Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:139102
Year Published:2020
Web of Science® Times Cited:2
Deposited By:Health Sciences
Deposited On:2020-05-26
Last Modified:2021-03-16
Downloads:6 View Download Statistics

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