When chronic conditions become emergencies - a report from regional Queensland.
OBJECTIVE
To describe chronic conditions and injuries as a proportion of total emergency presentations to a large public hospital in regional Queensland, and to investigate differences in presentation rates associated with Indigenous status.


METHODS
Cross-sectional analysis using Emergency Department Information System data between 1 July 2012 and 30 June 2014.


METHODS
Regional Queensland, Australia.


METHODS
A total of 95 238 emergency presentations were generated by 50 083 local residents living in the 10 statistical local areas (SLAs) immediately around the hospital.


METHODS
Emergency presentations for chronic conditions and injuries identified from discharge ICD-10-AM principal diagnosis. Age-standardised presentation rates were calculated using the Australian 2001 reference population.


RESULTS
Approximately half of all presentations were for chronic conditions (20.2%) and injuries (28.8%). Two-thirds of all chronic condition presentations were for mental and behavioural disorders (34.6%) and circulatory diseases (33.2%). Head injuries accounted for the highest proportion of injuries (18.9%). Age-standardised rates for major diagnostic groups were consistently higher for Indigenous residents, whose presentations were lower in mean age (95% CI) by 7.7 (7.3-8.1) years, 23% less likely to be potentially avoidable GP-type presentations [RR (95% CI) = 0.77 (0.75-0.80)], 30% more likely to arrive by ambulance [1.31 (1.28-1.33)] and 11% more likely to require hospital admission [1.11 (1.08-1.13)].


CONCLUSIONS
Opportunities exist to enhance current coordinated hospital avoidance and primary health services in regional Queensland targeting common mental and circulatory disorders, especially for Indigenous Australians.
Centre for Chronic Disease Prevention, AITHM, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia.|School of Health Sciences, Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
Linton R
LR
Harriss
Centre for Chronic Disease Prevention, AITHM, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia.
Fintan
F
Thompson
Centre for Chronic Disease Prevention, AITHM, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia.
Arindam
A
Dey
College of Healthcare Sciences, James Cook University, Cairns, Queensland, Australia.
Jane
J
Mills
College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia.
Kerrianne
K
Watt
Centre for Chronic Disease Prevention, AITHM, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia.|School of Health Sciences, Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
Robyn
R
McDermott
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology; D003422:Critical Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011793:Queensland / Q000453:epidemiology; D055815:Young Adult
Aboriginal; Indigenous; Torres Strait Islander; chronic disease; emergency department; health disparity; hospital avoidance