The Victorian Minister for Health and Ageing, The Honourable David Davis, opened Demography is Destiny: Emergency Care and Population Ageing Summit. Hosted by Monash University, the summit brings together key policy makers, researchers, emergency department (ED) clinicians and ambulance personnel to discuss strategies for ensuring the health system can respond to an ageing population.
Dr Judy Lowthian of Monash University’s Department of Epidemiology and Preventive Medicine organised the summit after her research revealed troubling patterns in emergency care utilisation.
“The volume and rate of emergency ambulance calls and ED presentations is increasingly dramatically – beyond what would be expected from population growth,” Dr Lowthian said.
“This rise has been disproportionately driven by older people, who are also at a higher risk of poorer outcomes and re-admission following an ED visit. For example, in a year-long period between 2008 and 2009, almost a quarter of ED presentations by patients aged 70 or over were made by people who attended four or more times over the course of a year.”
Dr Lowthian’s research showed an average annual increase in emergency transportations of almost five per cent in the 14 years to June 2008. Further increases of up to 69 per cent by 2015 were predicted.
ED presentations increased by an average of 3.6 per cent per year in the decade to June 2009 with the elderly accounting for the highest per capita rate of attendance. Hospital admissions from ED rose by 56 per cent over the same period.
To discuss the issues and develop possible solutions, the summit has brought together representatives from the Victorian Department of Health, Medicare Locals, public and private hospitals, community and aged care, as well as geriatricians, ED physicians and ambulance workers.
Dr Lowthian said various options for avoiding ED attendance and hospital admission would be discussed along with strategies for better integrating community and emergency care.
“ED attendance is not required in every case – at times, it’s a matter of a lack of alternatives. It may be possible that out-of-hospital services such as medical advice lines, extended care paramedics trained to treat patients, specialist outreach teams and coordinated multi-disciplinary community-based programs could help ease the strain on EDs,” Dr Lowthian said.
“Ultimately, what we’re aiming for is an integrated approach across the entire health system. Seamless coordination between emergency and community care will improve outcomes for older Australians.”
A discussion paper based on the summit will be available later in 2013.