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. DESIGN Cross-sectional analysis using Emergency Department Information System data between 1 July 2012 and 30 June 2014. SETTING Regional Queensland, Australia. PARTICIPANTS 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. MAIN OUTCOME MEASURES 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.