Mai Qun, Aboagye-Sarfo Patrick, Sanfilippo Frank M, Preen David B, Fatovich Daniel M
Clinical Modelling, Health System Improvement Unit, Innovation and Health System Reform, Department of Health Western Australia, Perth, Western Australia, Australia; Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Western Australia, Australia.
Emerg Med Australas. 2015 Feb;27(1):16-21. doi: 10.1111/1742-6723.12344. Epub 2015 Jan 13.
To predict the number of ED presentations in Western Australia (WA) in the next 5 years, stratified by place of treatment, age, triage and disposition.
We conducted a population-based time series analysis of 7 year monthly WA statewide ED presentation data from the financial years 2006/07 to 2012/13 using univariate autoregressive integrated moving average (ARIMA) and multivariate vector-ARIMA techniques.
ED presentations in WA were predicted to increase from 990,342 in 2012/13 to 1,250,991 (95% CI: 982,265-1,519,718) in 2017/18, an increase of 260,649 (or 26.3%). The majority of this increase would occur in metropolitan WA (84.2%). The compound annual growth rate (CAGR) in metropolitan WA in the next 5 years was predicted to be 6.5% compared with 2.0% in the non-metropolitan area. The greatest growth in metropolitan WA would be in ages 65 and over (CAGR, 6.9%), triage categories 2 and 3 (8.3% and 7.7%, respectively) and admitted (9.8%) cohorts. The only predicted decrease was triage category 5 (-5.3%).
ED demand in WA will exceed population growth. The highest growth will be in patients with complex care needs. An integrated system-wide strategy is urgently required to ensure access, quality and sustainability of the health system.
预测未来5年西澳大利亚州（WA）急诊科就诊人数，并按治疗地点、年龄、分诊和处置情况进行分层。
我们使用单变量自回归积分移动平均（ARIMA）和多变量向量自回归移动平均（VARIMA）技术，对2006/07财年至2012/13财年西澳大利亚州全州7年的月度急诊科就诊数据进行了基于人群的时间序列分析。
预计西澳大利亚州急诊科就诊人数将从2012/13年的990342人增加到2017/18年的1250991人（95%可信区间：982265 - 1519718），增加260649人（或26.3%）。这一增长的大部分将发生在西澳大利亚州的大都市地区（84.2%）。预计未来5年西澳大利亚州大都市地区的复合年增长率（CAGR）为6.5%，而非大都市地区为2.0%。西澳大利亚州大都市地区增长最快的将是65岁及以上人群（CAGR为6.9%）、分诊类别2和3（分别为8.3%和7.7%）以及收治人群（9.8%）。唯一预测下降的是分诊类别5（-5.3%）。
西澳大利亚州急诊科的需求将超过人口增长。增长最快的将是有复杂护理需求的患者。迫切需要一个全系统整合的战略，以确保卫生系统的可及性、质量和可持续性。
