Deck the halls with rows of trolleys...emergency departments are busiest over the Christmas holiday period.

OBJECTIVES

To assess changes in emergency department (ED) activity and visits to EDs that could have been managed by general practitioners (GP-type visits) in the Christmas and New Year holiday period compared with the rest of the year.

DESIGN AND SETTING

Retrospective descriptive and analytical comparison of New South Wales ED visits in the holiday period and the rest of the year; data were obtained from the NSW Emergency Department Data Collection database for the period 2001 to early 2006. More detailed information in 2005-2006 allowed GP-type visits to be assessed in this period only.

MAIN OUTCOME MEASURES

The change in the number and percentage of weekly ED visits during the holiday period.

RESULTS

Between 2001 and 2006, average weekly counts of ED visits increased by 9% (95% CI, 7%-11%) during the holiday period. The holiday increase was largely accounted for by visits that were less urgent, and for patients who were not admitted, did not arrive by ambulance, had a shorter treatment time and arrived between 08:00 and midnight. In 2005-2006, average weekly counts of GP-type visits increased by 21% (95% CI, 15%-28%) compared with 8% (95% CI, 4%-12%) for ED visits overall. However, GP-type visits accounted for only 39% of the additional holiday visits. GP-type visits increased mainly for adults and more in urban than rural areas.

CONCLUSIONS

The Christmas and New Year period is the busiest time of year for NSW EDs. However, only some of the additional holiday visits can be attributed to GP-type visits. Improving access to GPs, but also to broader hospital and community-based health care services over the holiday period, should be considered for managing the excess demand.