Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change

Burkett, Ellen; Martin‐Khan, Melinda; Scott, Judy E.; Samanta, Mayukh; Gray, Leonard C.

doi:10.1071/ah15165

Cited by 44 publications

(52 citation statements)

References 24 publications

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“…During this same period, the Australian population grew by an average of 1.56% per year (Australian Bureau of Statistics, 2012). ED presentations to 2050 are forecast to increase markedly, most significantly for older Australians, assuming population growth consistent with ABS projections (Burkett, Martin-Khan, Scott, Samanta, & Gray, 2016).…”

Section: The Main Problemmentioning

confidence: 79%

Models of evaluation under ceteris imparibus: System dynamics and the example of emergency care

2019

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Traditional and current approaches to modelling the impacts of health care interventions have focused on detail complexity and been ceteris paribus dependent and thereby ignored the wider system impacts. In this study, we have demonstrated that system dynamics (SD) offers theoretical and practical advantages over conventional methodologies and the qualitative assessment tools that have informed the business of emergency care. We translate the key findings of qualitative research, existing literature reviews and studies of the use of simulation and economic evaluation models into a value proposition for using SD tools. We conclude that there is growing evidence of a strong value proposition for the use of SD tools to investigate interventions targeting improved emergency care access. SD models can incorporate dynamic and organizational complexity and fill a gap beyond the microscope of the conventional methodologies informing health care. This potential to strengthen health care systems warrants further investigation.

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Section: The Main Problemmentioning

confidence: 79%

Models of evaluation under ceteris imparibus: System dynamics and the example of emergency care

2019

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“…This global phenomenon is a consequence of a decrease in fertility rates, childbearing later in life and an increase in life expectancy (United Nations, ). A healthcare impact of this trend is already visible, particularly in increasing presentations to hospital emergency departments (EDs) (Burkett, Martin‐Khan, Scott, Samanta, & Gray, ). It can be argued that many of these presentations can be avoided if improved access to primary care is available.…”

Section: Introductionmentioning

confidence: 99%

“…A healthcare impact of this trend is already visible, particularly in increasing presentations to hospital emergency departments (EDs) (Burkett, Martin-Khan, Scott, Samanta, & Gray, 2017). It can be argued that many of these presentations can be avoided if improved access to primary care is available.…”

Section: Introductionmentioning

confidence: 99%

Reasons for choosing or refusing care from a nurse practitioner: Results from a national population‐based survey

Craswell

Dwyer

2019

Journal of Advanced Nursing

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Aim To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services. Design This cross‐sectional, population‐based survey study used computer assisted telephone interviewing to elicit public opinions on the topic. Methods Data were collected in July and August 2015 from calls randomly placed to Australian households. Survey questions were developed from previous surveys and pilot tested. Summative content analysis was used to analyse open‐ended responses. Results Most respondents were always, or in some situations, willing to receive care from a nurse practitioner. The main themes identified from those willing to be seen by a nurse practitioner in any situation were, (a) appropriately qualified nurse practitioners, (b) the knowledge and experience to refer on if necessary. Description of situations from those unwilling to be seen by a nurse practitioner related to concern about appropriate care in a life‐threatening condition. Conclusion Respondents unwilling to consider any care from a nurse practitioner or care in an emergency situation, reveal a lack of understanding of their role in the wider healthcare team. As the number of nurse practitioners increase, professional groups and community awareness programmes should be focused on explaining and promoting their essential role. Impact This study addresses the increasing healthcare requirements of ageing populations through understanding acceptance by society to the provision of care from health professionals other than medical practitioners. Most respondents were willing to be seen by a nurse practitioner for all or most of their healthcare needs. Lack of understanding of their scope of practice and role in the wider healthcare team, particularly in emergency situations, was reflected in responses. Those who would refuse care from a NP were in the minority. Appropriateness and acceptability of the roles of health professionals to provide quality care collaboration need consideration by policy makers.

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“…Subsequently, the patients take decisions and actions that impact on their own health, an ED and health system care outcomes . Understanding and responding effectively to this issue is critical to realizing enhancements in the quality of care and outcomes for individuals, patient cohorts, the functioning of EDs and the hospitals that encompass them, and the health system more broadly …”

Section: Introductionmentioning

confidence: 99%

Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

Siddiqui

Greenfield

Lawler

2019

Health Planning & Management

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Understanding the influence of a telephone triage advice service (TTAS) on patients seeking care is critical to realize enhancements in patient care, functioning of emergency departments (EDs), and effectiveness of the health system. This study addresses the question: what influence does a TTAS have on a patient's attendance at an ED and the wider health system? Records from 2016 to 2017 of 12,741 calls from a national TTAS were linked to 72,577 ED presentations to a hospital in regional Australia, retrospectively. Matching criteria included patient within the hospital's statistical local area code, age, gender, and ED attendance within 8 hours of TTAS call. Five statistical analyses of the data were conducted. There were 2857 matches. TTAS patients accessing the ED had a slightly higher proportion of women and a greater proportion of children under 4 years than usual. When TTAS confirmed callers' inclination for ED care, however only up to 69% subsequently attended the ED. When TTAS redirected others initially less inclined to more urgent care, up to 62% attended the ED. TTAS empowers vulnerable patients to access appropriate and timely services and promotes clinical and functional integration of care. Improvements of TTAS can come through investigation of callers' compliance factors. K E Y W O R D S appropriate care, care integration, emergency department health system, telephone triage advice service

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Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change

Cited by 44 publications

References 24 publications

Models of evaluation under ceteris imparibus: System dynamics and the example of emergency care

Models of evaluation under ceteris imparibus: System dynamics and the example of emergency care

Reasons for choosing or refusing care from a nurse practitioner: Results from a national population‐based survey

Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

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