Prevalence of access block in Australia 2004-2008

Richardson, Drew, Kelly, Anne-Maree and Kerr, Debra 2009, Prevalence of access block in Australia 2004-2008, Emergency medicine Australasia, vol. 21, no. 6, pp. 472-478, doi: 10.1111/j.1742-6723.2009.01241.x.

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Title Prevalence of access block in Australia 2004-2008
Author(s) Richardson, Drew
Kelly, Anne-Maree
Kerr, DebraORCID iD for Kerr, Debra orcid.org/0000-0002-2956-2432
Journal name Emergency medicine Australasia
Volume number 21
Issue number 6
Start page 472
End page 478
Total pages 7
Publisher Wiley-Blackwell Asia
Place of publication Milton, Qld.
Publication date 2009-12
ISSN 1742-6731
1742-6723
Keyword(s) access block
emergency
overcrowding
prevalence
Summary OBJECTIVE: Access block is the inability of ED patients requiring admission to access appropriate inpatient beds in a timely fashion, defined in Australasia as more than 8 h in the ED. The present study describes changes in prevalence of access block in Australia over a 4 year period.

METHODS: Email, telephone and fax survey of ED on six Mondays at 10.00 hours (31 May, 30 August 2004, 18 June, 3 September 2007, 2 June, 2 September 2008). Data collected included point data on the status of patients in the ED at the index time and of recent ED attendance numbers. Results were collated and analysed by state and hospital role delineation.

RESULTS: Forty-eight (60%) of 80 eligible ED answered all six surveys. Presentations to the ED the day before rose 15% (P < 0.0001, paired t-test) in 4 years, and nationally access block patients in the ED rose an average of 27%, and patients waiting to be seen by a doctor 31%. There were differences between states, with hospitals in New South Wales reporting a significant reduction in access block patients (-51%, P= 0.0002), but all other states a significant increase (+45%, P= 0.001). There were differences by role delineation, with non-paediatric major referral hospitals experiencing the greatest access block, but smaller hospitals experiencing the greatest increase in patients waiting.

CONCLUSIONS: Around one-third of all patients receiving care in these ED surveys were experiencing access block. There is evidence that flow through New South Wales ED has improved. The data suggest that most hospitals have passed the point of efficiency.
Language eng
DOI 10.1111/j.1742-6723.2009.01241.x
Field of Research 110399 Clinical Sciences not elsewhere classified
1103 Clinical Sciences
1117 Public Health And Health Services
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2009, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089873

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