Emergency department use in developed countries
A global study undertaken by George Washington University has evaluated the use of emergency departments in seven developed countries and has identified areas where efficiencies are needed.
The study, conducted with Royal Philips researchers, found that Australia has a low use of emergency departments when compared to Canada, the US, the UK, the Netherlands, Switzerland and Germany.
This finding points to Australia’s strong access to primary care resulting in less frequent use of emergency resources.
The paper, Acute unscheduled care in seven developed nations: a cross-country comparison, compares the similarities and differences across nations with a focus on care delivery and the impact of socio-economic factors.
The research from Philips and the GWU School of Medicine and Health Sciences reveals unsustainable ED use in some developed nations.
Better access to primary care can result in lower ED use.
The findings of the report show Germany (22 per cent) and Australia (22 per cent) as having the lowest ED use, likely resulting from better and faster access to primary care — nearly two-thirds of Australians (58 per cent) and three-quarters of Germans (72 per cent) were able to make same or next day appointments with their primary care physicians (PCPs) compared to less than half of Americans (48 per cent) and Canadians (41 per cent).
“In looking at the way emergency departments are used around the world, we were able to obtain valuable new insights to help improve care delivery,” said Jesse Pines, from GWU.
“Because of research findings presented in this report, all emergency departments, no matter their location, have the opportunity to efficiently improve the way care is delivered in emergency department settings.”
Kevin Barrow, managing director of Philips Australia and New Zealand said the research shows Australia ranked relatively well when it comes to hospital emergency department admissions.
“And (for) the cost of health care for both government and individuals, in comparison to other countries surveyed, reflecting the relative ease of access to primary care in our country,” he said
“However, the findings also identified a need to improve departmental efficiencies and increase activities to minimise the burden on acute care facilities, by continuing to focus on preventive care, chronic disease management and the education of patients on the appropriate care for their health needs.”
Data has been formulated into a list of key areas researchers say impact the way care is delivered in emergency settings, and the broad differences in available treatments across countries.
• Social determinants (smoking, eating, violence, substance abuse and poverty) have a strong impact on the use of EDs;
• Reduced access to health insurance results in poorer population health; placing a greater strain on emergency departments;
• Sick patients do not make the most efficient decisions about when and where to seek medical care;
• Extensive provider training is mandatory for effective delivery of acute unscheduled care; and
• Quality measures for EDs are immature and not standardised.
“There’s a belief that easy access to primary care can result in lower emergency department use,” said Mark Feinberg of Philips North America.
“However, as a result of this report, it is clear that even if people have easy access to primary care and full healthcare coverage, there is no guarantee the patients will make economically prudent decisions to seek the most appropriate medical care setting.”
The complete report can be accessed at: www.healthsystems.philips.com/acute-unscheduled-care