02223nas a2200181 4500000000100000008004100001100001300042700001800055700001200073700001200085700002500097700001600122700001500138245015700153250001500310520166500325020005101990 2016 d1 aIvers R.1 aMuscatello D.1 aDinh M.1 aBein K.1 aS. Russell Berendsen1 aChalkley D.1 aPaoloni R.00aTrends and characteristics of short-term and frequent representations to emergency departments: A population-based study from New South Wales, Australia a2016/05/063 a

OBJECTIVE: The objective of this study is to describe the trends and characteristics of short-term and frequent representations to EDs in New South Wales, Australia. METHODS: This 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 3 days of discharge from ED, readmission to an in-patient unit within 30 days of index in-patient admission from ED and demographic data and trends for frequent and very frequent ED presenters is discussed. RESULTS: A total of 10 798 797 ED presentations were identified from 4 188 283 individual patients. Within 1 year, 48.9% of ED presentations had a previous presentation, and 4.9% had represented within 3 days of a previous presentation. The readmission rate within 30 days 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 3 days has decreased from 5.1% in 2010 to 4.7% in 2014 (P < 0.001). The rate of readmissions within 30 days has increased from 2.4% in 2010 to 3.1% in 2014 (P < 0.001). CONCLUSIONS: In 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.

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