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Get in (very) early to skip the ED crush


Patients trying to avoid the crowds in public hospital emergency departments will need to get up very early, or stay up very late.

An analysis of emergency department presentations has found that late mornings and early afternoons are the worst times to arrive, with almost 13 per cent of patients bowling up between10am and noon, and more than 12 per cent coming in between noon and 2 pm.

By contrast, the quietest time is between 4am and 6am, when just 2.5 per cent of all daily presentations are made.

The analysis by the Australian Institute of Health and Welfare shows that patients surge into emergency departments from 8am, and the pace of arrivals does not really tail off until after 10pm.

The greatest fluctuation is among patients with conditions classified as urgent and semi-urgent – most of such presentations occur between 8am and 8pm.

By contrast, there is little daily variation in when patients in need of resuscitation – the most urgent level of care – arrive, while the number of emergency cases fluctuates between less than 20,000 and more than 40,000 every two hours, depending on the time of day.

While demand for emergency department care fluctuates during the day, the Institute figures show any quiet time during the week is likely to be brief.

The influx of patients during the week is remarkably even. The busiest days are Sundays and Mondays, when slightly more than 15 per cent of total weekly presentations will arrive each day, while during even the quietest days (Wednesday, Thursday and Fridays) still 13.7 per cent of total weekly presentation will come through the door each day.

But for those concerned about the extent of alcohol-fuelled violence and harm in the community, the figures shed little light.

Though they show a small increase in emergency department presentations in the early hours of Saturdays and Sundays, the rise is slight, and the data do not disaggregate presentations by diagnosis.

Adrian Rollins