Growth in Western Australian emergency department demand during 2007-2013 is due to XXXX with urgent and complex care needs.

@entity1 @entity2613
OBJECTIVES: To determine the magnitude and characteristics of the increase in @entity2613 demand in Western Australia (WA) from 2007 to 2013. METHODS: We conducted a population-based longitudinal study examining trends in @entity2613 demand, stratified by area of residence, age group, sex, Australasian Triage Scale category and discharge disposition. The outcome measures were annual number and rate of @entity2613 presentations. We calculated average annual growth, and age-specific and age-standardised rates. We assessed the statistical significance of trends, overall and within each category, using the Mann-Kendall trend test and analysis of variance ANOVA. We also calculated the proportions of growth in @entity2613 demand that were attributable to changes in population and utilisation rate. RESULTS: From 2007 to 2013, @entity2613 presentations increased by an average 4.6% annually from 739   742 to 945   244. The rate increased 1.4% from 354.1 to 382.6 per 1000 WA population (P = 0.02 for the trend). The main increase occurred in metropolitan WA, age 45+ years, triage category 2 and 3 and admitted cohorts. Approximately three-quarters of this increase was due to population change (growth and ageing) and one-quarter due to increase in utilisation. CONCLUSION: Our study reveals a 4.6% annual increase in @entity2613 demand in WA in 2007-2013, mostly because of an increase in @entity1 with urgent and complex care needs, and not a shift (demand transfer) from primary care. This indicates that a system-wide integrated approach is required for demand management.
