Dinh Michael M, Bein Kendall J, Latt Mark, Chalkley Dane, Muscatello David
Discipline of Emergency Medicine, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Emerg Med J. 2015 Sep;32(9):708-11. doi: 10.1136/emermed-2014-204174. Epub 2014 Dec 18.
To contrast long-term population-based trends in general practice (GP) presentations and acute inpatient admissions from the emergency department (ED) in the elderly population within the Greater Sydney Area.
This was a retrospective analysis of population-based ED presentation data over 11 years, between January 2001 and December 2011, conducted within the Greater Sydney Area in Australia. De-identified data were obtained from the New South Wales Emergency Department Data Collection database on all patients presenting to 30 public hospital EDs located within the Greater Sydney Area. The outcomes of interest were GP presentations to ED (triage category 4 or 5, self-referred and discharged from ED) and of acute inpatient admissions from ED per 1000 population.
Over 11 million presentations were identified. Around 40% of presentations were classified as a GP presentation and 23% were classified as acute inpatient admissions. There was a 2.9% per annum increase in acute inpatient admissions per 1000 population in those ≥80 years of age and no appreciable change in other age groups. Rates of GP presentations were higher in those <65 years of age. GP presentations increased 1.9% per annum in those aged <65 years of age.
The increase in ED demand appears to be driven by the elderly presenting with acute problems requiring inpatient admission. There has been a modest increase in the rate of GP presentations to ED.
对比大悉尼地区老年人群在全科医疗（GP）就诊及从急诊科（ED）急性住院的长期基于人群的趋势。
这是一项对2001年1月至2011年12月期间澳大利亚大悉尼地区11年基于人群的急诊科就诊数据的回顾性分析。从新南威尔士州急诊科数据收集数据库获取了去识别化数据，这些数据涉及所有前往大悉尼地区30家公立医院急诊科就诊的患者。感兴趣的结果是每1000人口中到急诊科的全科医疗就诊情况（分诊类别4或5，自行前往并从急诊科出院）以及急诊科急性住院情况。
共识别出超过1100万次就诊。约40%的就诊被归类为全科医疗就诊，23%被归类为急性住院。80岁及以上人群每1000人口急性住院人数每年增加2.9%，其他年龄组无明显变化。65岁以下人群的全科医疗就诊率更高。65岁以下人群的全科医疗就诊人数每年增加1.9%。
急诊科需求的增加似乎是由患有需要住院治疗的急性问题的老年人推动的。到急诊科的全科医疗就诊率有适度增加。
