examining data trends in nsw emergency departments from 2010-2015,
TRANSCRIPT
Michael M Dinh
Emergency Physician & Clinical Associate Professor
Royal Prince Alfred Hospital &The University of Sydney
DESTINY: Demand for Emergency Services Trends in Years 2010-2015
Funders
NSW Agency for Clinical Innovation, Emergency Care
Institute Research Grant 2014
Partner Organisations
NSW Ministry of Health, Centre for Epidemiology and
Evidence
Centre for Health Record Linkage (CHeReL)
The George Institute for Global Health The University of
Sydney
Royal Prince Alfred Hospital, Sydney Local Health District
Research
Co-Investigators
Saartje Berendsen, Russell RPA ED CNC
Kendall Bein, RPA Emergency Physician
Rebecca Ivers, Injury Division The George Institute for
Global Health
David Muscatello, School of Public Health UNSW
Dane Chalkley, RPA Emergency Physician
Richard Paoloni, Concord Emergency Physician
Background
Background
The Age, July 2013
Objectives
Exploratory analysis of Emergency Department Data
Collection Registry 2010-2014
Describe major trends and patterns of presentations
Modelling trends, predictors of outcomes and forecasting
Data source
Emergency Department Data Collection Registry
150 EDs
Presenting problem, ED diagnoses, triage category, mode
of arrival and mode of separation
Linked to patient identifier
Exclusions
Small EDs with no data in 2010-12
Transfers from other health facilities
Dead on arrival
Planned representations
Data variables
Variable Coding Definition
Age Age in years, and in 5 yearly increments
Sex Male/Female/indeterminate/unknown
Date and time of arrival Time of first encounter (triage or registration) in Emergency Department
Mode of arrival Self, ambulance, police
Mode of separation Admitted (ward or intensive care), discharged, died, transferred to another health facility
Presenting problem Triage nurse-entered clinical problem
ED Diagnosis SNOMED-CT or ICD (10AM and 9CM) versions
Triage category Australasian triage category 1 (immediately life threatening) to 5 (non urgent)
ED visit type Planned representation or emergency visit
ED Length of stay (hours) Time between ED arrival date/time and ED departure date/time
Data cleaning
ED diagnoses 60% SNOMED 30% ICD codes 10% missing
or uncodable
– 7000 codes = 95% of all presentations
Presenting problem – standard fields and free text
– 5000+ presenting problem types (400 main presenting
problems)
Categorisation into 20 classes
ED diagnostic categories
Abdominal gastrointestinal
Cardiovascular
Fever sepsis
Injury musculoskeletal
Mental Health
Toxicology
Neurology
Other medical
Obstetrics Gynaecology
ENT Eye
Administrative
Social
Results
11.8 million presentations to 150 NSW EDs from 4.3 million
individuals
10.8 million presentations after exclusions were analysed
RESULTS
0
100
200
300
400
500
600
700
800
900
Ra
te p
er
10
00
po
pu
latio
n
Age group (years)
RESULTS
Most common ED diagnosis categories
– injury/musculoskeletal (27.5%)
– abdominal/gastrointestinal (12.3%)
– respiratory (9%)
– cardiovascular (8%)
Presenting problem list PRESENTING COUNT
PAIN, ABDOMINAL 508176
PAIN, CHEST 386568
UNWELL 260451
FEVER 254157
INJURY - LACERATION 226868
RESPIRATORY - SHORTNESS OF BREATH 224966
VOMITING 173084
RESPIRATORY - COUGH 159178
CARE - PATIENT REVIEW 150387
HEADACHE 143771
INJURY - LIMB 141819
PAIN, BACK 140720
OTHER 135071
INJURY - UPPER LIMB 128805
INJURY - LOWER LIMB 110865
REVIEW 109876
RASH 103450
INJURY - HEAD 102080
PAIN, LIMB LOWER 96120
CHEST PAIN 95597
DIZZINESS 86294
PAIN, LIMB LOWER / HIP 81502
PAIN - ABDOMINAL 79427
PAIN, OTHER 78507
Redundancy
Abdominal pain
Pain, Abdomen
Abdominal pain, adult
Abdo pain (L, R,LUQ RUQ lower upper epigastric LLQ, left sided,
right sided, LUQ)
Pain, abdo
Pain, abdominal
Pain - abdomen
“Abod apin”
ED diagnoses
SNOMED
CODE
DESCRIPTION
21522001 ABDOMINAL PAIN
314212008 ABDOMINAL PAIN - CAUSE UNKNOWN
79922009 EPIGASTRIC PAIN
54586004 LOWER ABDOMINAL PAIN
9991008 COLICKY ABDOMINAL PAIN
285388000 RIGHT SIDED ABDOMINAL PAIN
116290004 ACUTE ABDOMINAL PAIN
162051008 RIF - RIGHT ILIAC FOSSA PAIN
83132003 UPPER ABDOMINAL PAIN
207205003 [D]ABDOMINAL PAIN (SITUATION)
9209005 ACUTE ABDOMEN
304542004 NONSPECIFIC ABDOMINAL PAIN
301717006 RIGHT UPPER QUADRANT PAIN
162046002 CENTRAL ABDOMINAL PAIN
102614006 GENERALISED ABDOMINAL PAIN
439469002 RECURRENT ABDOMINAL PAIN
111985007 CHRONIC ABDOMINAL PAIN
SNOMED codes
SNOMED CODE DESCRIPTION
372286000 PATHOLOGY EXAMINATION FINDINGS PRESENT
105620001 EFFECT OF FOREIGN BODY (DISORDER)
301327002 GOK - GOD ONLY KNOWS
125670008 FB - FOREIGN BODY OF BODY STRUCTURE
19227008 FOREIGN BODY
247342009 FBS - FOREIGN BODY SENSATION
211616004 FOREIGN BODY (FB) IN ORIFICE
33962009 CHIEF COMPLAINT (FINDING)
305633005 SEEN BY ACCIDENT AND EMERGENCY DOCTOR
(FINDING)
261665006 UNKNOWN (QUALIFIER VALUE)
74964007 OTHER
185296009 SEEN BY HOSPITAL NURSE (FINDING)
305731000 SEEN BY NURSE (FINDING)
308930007 SEEN BY HEALTH PROFESSIONAL (FINDING)
304534000 CRYING (FINDING)
168501001 RADIOLOGY RESULT ABNORMAL
308032002 SEEN BY RADIOLOGY - SERVICE (FINDING)
185181002 SEEN IN RADIOLOGY DEPARTMENT (FINDING)
185294007 SEEN BY REGISTRAR (FINDING)
275645009 NURSE: REFERRED TO (FINDING)
314850005 SEEN BY TRIAGE NURSE (FINDING)
162213003 CRYING, EXCESSIVE
LOW ACUITY
Self presented, triage
category four or five,
discharged from ED
10.7 million ED
presentations analysed.
45% were classified as
a low acuity
presentation.
Rate of low acuity emergency department
presentation per 1000 population
LOW ACUITY FINDINGS
No discernible increase in the rate of low acuity
presentations across NSW between 2010 and 2014.
The strongest predictors of low acuity ED presentation
were
– age less than 40 years of age
– Injury, musculoskeletal problems, administrative and non
urgent procedures, ear nose and throat, eye or oral, skin
or allergy type presenting problems
AMBULANCE TRANSPORTS
10.8 million ED attendances
2.6 million (23%) transported to ED by ambulance.
The crude rate of ambulance transportations to EDs across
all ages increased by 3.0% per annum over the five years
Percentage of cases transported by NSW Ambulance
to NSW EDs by ED allocated Australasian Triage
Scale (ATS) triage category: 2010-14
0
5
10
15
20
25
30
35
40
45
50
2010 2011 2012 2013 2014
% ATS 1 and 2
ATS 3
ATS 4 and 5
AMBULANCE TRANSPORTS
The highest rate was observed in those 85 years and over
(620.5 presentations per 1000 population).
There was an increase in the proportion of category 1 and
2 (life-threatening or potentially life-threatening) cases from
18.1% to 24.0%.
0
100
200
300
400
500
600
0-4
5-9
10
-14
15
-19
20
-24
25
-29
30
-34
35
-39
40
-44
45
-49
50
-54
55
-59
60
-64
65
-69
70
-74
75
-79
80
-84
85
+
pre
sen
tati
on
s p
er
1000
po
pu
lati
on
Age group
2010
2014
ATS 1 AND 2 (IMMEDIATELY OR IMMINENTLY LIFE-THREATENING)
CASES TRANSPORTED BY AMBULANCE TO NSW ED
0
20
40
60
80
100
120
2010 2011 2012 2013 2014
Am
bu
lan
ce t
ran
sp
ort
s p
er
1000 p
op
ula
tio
n
Year
0-9
10-19
20-39
40-59
60-79
80+
REPRESENTATIONS
10,798,797 ED presentations were identified from
4,188,283 individual patients.
48.9% of ED presentations had a previous presentation
within one year
4.9% had represented within 3 days of a previous
presentation.
REPRESENTATIONS
The overall rate of representations within 3 days has
decreased from 5.1% in 2010 to 4.7% in 2014 (p<0.001).
The rate of readmissions within 30 days has increased
from 2.4% in 2010 to 3.1% in 2014 (p<0.001).
The proportion of frequent (representing 5,212 (0.1%)
individual patients) and very frequent representations
(representing 1,186 (0.03%) individual patients) were 1.7%
and 1.0% respectively.
REPRESENTATIONS
Short term representations were highest in the infant
patient population
In-patient readmission rates were highest in the elderly
Very frequent representations to ED were characterised by
middle aged patients with mental health or drug and alcohol
related presentations.
REPRESENTATIONS
15-29 Presentations PA 30+ Presentations PA
INJURY
A total of 2.09 million injury related ED presentations were
analysed.
Minor injury (discharged home) comprised 85%
Serious injury (admitted) comprised 14.1%
Critical injuries (triage cat 1,2 and admitted to ICU or OT or
died) comprised 1%
INJURY
There was a 15.8% per annum increase in the rate of
critical injuries per 1000 population in those 80 years and
over, with the most common diagnosis being head injuries.
Around 40% of critical injuries presented directly to a major
trauma centre.
Injury presentation patterns
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
2010 2011 2012 2013 2014
Rate
per
1000 p
op
ula
tio
n
Critical injury
0-9yrs
10-19yrs
20-39yrs
40-59yrs
60-79yrs
80+yrs
0
10
20
30
40
50
60
70
80
2010 2011 2012 2013 2014R
ate
per
1000 p
opula
tion
Serious injury
0-9yrs
10-19yrs
20-39yrs
40-59yrs
60-79yrs
80+yrs
Minor injuries relatively stable
0
10
20
30
40
50
60
70
80
90
100
2010 2011 2012 2013 2014
Rate
per
1000 p
opula
tion
Minor injury
0-9yrs
10-19yrs
20-39yrs
40-59yrs
60-79yrs
80+yrs
M…3
…6…9
…1…1
…1…2
…
0
200
400
600
800
1000
1200
1400
1600
1800
JA
JO
JA
JO
JA
JO
JA
JO
JA
JO
Number of patients in
ED
Modelling ED demand
Hour of day Time series (months)
139.67742 129.32143 132.25806 123.86667 119.70968 120.36667 121.32258 123.25806 126.73333 135.64516 138.3 145.29032 145.3871 146.5 137.35484 128.16667 120.70968 127.56667 129.87097 129.93548 131.16667 134.74194 138.66667 146.67742 147.3871 141.17241 145.96774 148.23333 133.58065 145.5 134.74194 129 134.43333 142.09677 145.9 161.16129 158.19355 148.82143 156.48387 141.63333 132.09677 145.33333 138.64516 144.54839 145.43333 143.03226 142.83333 163 155.3871 153.64286 162.70968 157.33333 141.19355 142.73333 142.45161 147.45161 141.63333 143.90323 156.7 161.12903
116.64516 106.64286 108.45161 102.66667 98.290323 98.066667 100.41935 97.129032 104.1 111.58065 108.23333 119.6129 115.51613 111.53571 111.22581 104.8 100.19355 97.766667 103.09677 106.96774 100.83333 108.3871 112.33333 117.83871 116.3871 111.75862 117.93548 116.1 110.09677 117.16667 111.70968 106.83871 109.23333 108.90323 116.76667 128.06452 131.06452 120.28571 127.3871 113.46667 104.32258 115.8 116.25806 116.32258 114.9 116.77419 115.7 126.3871 125.54839 119.57143 125.32258 120.93333 111.74194 111.23333 110.22581 119.87097 115.8 116.58065 125.7 131.22581
95.935484 91.178571 89.483871 87.733333 83.741935 83.766667 82.83871 81.258065 88.2 91.806452 90.533333 99.516129 97.483871 92.678571 92.064516 93.4 84.193548 85.933333 87.16129 87.451613 88.066667 87.354839 95.6 104.06452 99.451613 99.551724 96.645161 103.13333 91.580645 96.366667 95.387097 89.967742 96.3 87.322581 95.5 109.32258 110.35484 99.285714 106.74194 94.466667 88.645161 94.166667 92.096774 93.387097 96 92.903226 98.266667 108.54839 107.77419 105.67857 107.35484 104.73333 93.645161 94.4 91.967742 104 92.933333 93.806452 101.26667 109.70968
82.548387 78.678571 78.096774 71.3 69.870968 68.666667 73.516129 72.193548 74.133333 82.193548 82.033333 83.129032 88.870968 85.428571 78.193548 79.8 71.645161 76.733333 76.774194 76.580645 77.266667 75.83871 79.066667 86.903226 83.419355 84.413793 87.774194 87.733333 81.193548 82.5 83.580645 80.354839 81.433333 80.548387 83.733333 95.16129 94.483871 83.607143 88.709677 88.033333 82.193548 83 84.322581 87.322581 83.1 86.548387 82.5 93.387097 93.032258 85.178571 94.645161 92.833333 81.83871 80.8 85.354839 87.387097 86.6 86.193548 92.3 95.903226
74.645161 67.857143 70.645161 65.7 68.225806 65.6 64.580645 67.16129 68.4 70.903226 73.3 73.903226 75.612903 76.321429 71.193548 70.4 63.258065 70.533333 68.774194 72.870968 67.466667 70.064516 72.9 77 76.290323 74.103448 75.16129 77.1 71.387097 81.8 75.354839 73.16129 74.033333 75.129032 75.533333 88.903226 83.774194 75.607143 83.419355 74.9 73.032258 78.533333 78.064516 78.096774 77.766667 76.129032 76.933333 82.354839 81 78.964286 84.870968 81.8 73.612903 77.633333 72.612903 81.096774 75.2 77.064516 79.2 82.290323
68.516129 67.035714 67.741935 66.033333 62.129032 59.766667 63 64.83871 67.5 70.032258 71.266667 73.548387 76.548387 70.214286 71.741935 71.033333 63.354839 65.9 68.129032 70.129032 67.233333 68.645161 72.166667 77.870968 74.806452 71.862069 74.096774 78.766667 69.580645 76.4 76.451613 68.677419 73.6 72.451613 76.9 85.225806 81.967742 74.464286 80.354839 75.433333 70.548387 75.3 71.806452 78.483871 80.633333 78.129032 75.633333 84.451613 79.290323 82.607143 81.870968 79.7 72.580645 72.7 73.032258 78 77.1 78.83871 84.133333 85.258065
87.967742 83.214286 82.16129 85.6 82.193548 78.133333 80.322581 80.290323 95.033333 86.516129 94.3 101.74194 95.935484 88.928571 85.83871 90.466667 84.387097 83.1 85.387097 94.387097 96 89.354839 101.2 104.64516 94.419355 91.793103 91.032258 110.26667 95.354839 96.866667 92.967742 92.612903 104.56667 94.677419 100.4 114.48387 103.12903 94 99.290323 101.66667 90.258065 91.866667 91.967742 99.354839 106.26667 96.064516 102.93333 112.58065 102.03226 94.321429 100.74194 105.06667 96.193548 92.7 94.548387 101.19355 107.5 99.258065 111.03333 118.19355
142.77419 136.57143 130.83871 148.8 130.51613 122.2 123.29032 132.03226 153.26667 145.35484 153.7 160.58065 157.25806 147.60714 134.45161 151.93333 129.96774 131.26667 134.35484 149.22581 159.33333 149 160.6 171.6129 155.41935 148.31034 142.25806 176.83333 146.90323 150.43333 144.16129 153.09677 167.33333 153.29032 159.93333 183.83871 167.58065 149.14286 152.22581 165.16667 147.6129 144.76667 143.58065 155.58065 175.16667 161.6129 167.76667 189.64516 165.54839 156.17857 150.51613 169.8 149.41935 145.06667 138.22581 157.29032 172.43333 162.25806 175.86667 186.83871
231 222.96429 220.58065 235.2 220 213.33333 206.29032 222.90323 242.13333 230.48387 246.36667 254.74194 245.22581 236.07143 227.41935 248.73333 226.58065 220.43333 223.22581 247.29032 250.33333 237.64516 252.83333 275 244.80645 240.68966 235.12903 280.76667 251.87097 248.7 246.67742 247.29032 267.33333 247.16129 253.66667 285.70968 269.80645 246.42857 255.48387 259.2 250.19355 246.66667 234.87097 267.77419 280.06667 262.03226 258.4 289.90323 258.70968 251.28571 252.29032 275 246.32258 237.4 238.93548 258.3871 266.16667 259.70968 274.56667 285.32258
295.93548 297.96429 307.83871 313.1 299.93548 306.63333 282.64516 312.96774 331.23333 317.06452 319.06667 340.70968 323.80645 320.89286 318.06452 322.73333 315.74194 315.26667 319.70968 347.96774 342.5 321.22581 333.06667 358.19355 336.19355 335.27586 333.29032 373.5 355.19355 357.66667 344.96774 349.77419 359.66667 335.41935 343.13333 378.06452 352.48387 346.35714 366.09677 351.2 352.29032 348.33333 336.35484 378.35484 366.8 354.87097 348.4 384.32258 354.29032 354.92857 372.48387 377.36667 354.48387 345.8 337.96774 374.03226 353.36667 355 363.03333 379.41935
341.06452 330.14286 344.83871 343.5 334.3871 337.06667 329.03226 349.87097 357 349.45161 356.9 362.35484 375.80645 354.07143 344.67742 353.4 348.41935 358.26667 366.16129 382.12903 361.1 362.77419 360.93333 394.25806 377.87097 361.96552 375.58065 406.86667 391.29032 404.8 392.51613 383.48387 388.36667 373.22581 377.06667 410.93548 406.16129 383.28571 411.6129 396.5 387.45161 397.9 391.67742 415.06452 406 391.96774 388.36667 424.48387 401.41935 398.92857 408.29032 417.96667 395 401.46667 385.58065 417.51613 392.33333 396.54839 400.76667 421.80645
339 333.03571 337.96774 341.06667 335.3871 343.6 329.3871 350.16129 353.63333 350.90323 345.13333 364.51613 372.09677 352.21429 346.09677 355.6 348.67742 363.63333 374.67742 373.16129 358.03333 360.54839 355.46667 387.74194 383.77419 367.82759 373.09677 401.6 396.77419 411.33333 396.3871 396.22581 385.13333 377.45161 374.13333 408.58065 406.25806 382 408.3871 398.03333 386.19355 397.93333 397.29032 419.67742 404.9 395.41935 385.86667 420.83871 409.80645 398.10714 412.93548 416.1 402.32258 406.86667 403.3871 428.29032 398.86667 409.3871 404.86667 423.06452
320.93548 319.35714 319.74194 321.03333 319.67742 325 317.87097 327.32258 333.03333 324.67742 319.6 341.93548 349.3871 331.46429 329.41935 332.73333 343.29032 341 350.90323 358.35484 338.8 346.51613 342.9 356.87097 359.80645 344.48276 354.45161 380.7 379.19355 391.96667 386.35484 386.74194 367.3 360.51613 352.73333 386.29032 381.48387 365.64286 383.41935 377.76667 381.90323 386 388.29032 401.6129 381.46667 376.58065 369.63333 394.83871 385 378.92857 399.51613 389.63333 393.45161 388.86667 388.48387 414.45161 384.5 386.77419 389.86667 393.90323
308.29032 302.46429 302.87097 302.43333 310.22581 317.5 312.03226 317.70968 317.53333 318.16129 314.3 321.45161 331.19355 310.21429 312.96774 324.4 331.48387 334.3 347.83871 349.22581 329.26667 329.06452 328.53333 342.32258 343.83871 329.34483 339.77419 363.46667 367.51613 379.26667 373.74194 364.77419 356.56667 346.6129 342.63333 365.70968 365.90323 357.17857 376.77419 368.26667 377 376.03333 369.45161 396.12903 367 365.90323 360.1 371.51613 375.45161 365.32143 375.64516 384.56667 382.12903 381.83333 380.77419 396.09677 377.7 372.06452 370.96667 380.70968
296.96774 283.35714 293.6129 304.23333 302.09677 307.86667 300.80645 305.25806 314.76667 309.29032 301 312.64516 321.64516 299.25 305.90323 316.3 326.54839 325.93333 338.35484 334.87097 319.36667 316.93548 311.7 334.25806 327.51613 318.37931 334.3871 359.36667 358.3871 364.5 361.6129 351.58065 351.96667 324.35484 329.7 350.32258 352.41935 336.42857 360.3871 358.9 362.80645 365.66667 368.70968 382.87097 363.8 353.35484 342.66667 365.09677 358 347.75 368.19355 378.2 369.41935 372 372.64516 382.29032 360 356.06452 367.53333 371.06452
286.74194 276.82143 291 291.5 293.58065 300.3 300.03226 307.70968 308.7 302.90323 292.6 305.64516 308.74194 294.57143 303.67742 312.4 312.48387 318.93333 326.22581 326.90323 322.23333 310.22581 308.63333 325.58065 323.83871 308.72414 327.74194 346.86667 356.12903 360.23333 354.67742 350.6129 347.33333 331.03226 326.56667 344.64516 345.32258 326.78571 356.87097 361.16667 358.90323 358.36667 360.64516 377.74194 363.4 346.51613 334.8 360.54839 354.29032 340.35714 365.41935 375.1 363.70968 369.86667 371 384.16129 359.16667 355.87097 350.73333 362.3871
288.19355 288.25 297.80645 297.53333 312.09677 304.73333 303.58065 316.67742 314.7 308.58065 308.4 315.64516 314.74194 310.53571 305.32258 314.83333 327.45161 322.53333 333.25806 336.67742 324.63333 315.6129 318.66667 332.51613 320.06452 332.68966 337.70968 361.33333 367.29032 361.93333 359.6129 359.19355 353.46667 339.35484 338.8 349.54839 341.90323 337.89286 364.67742 363.96667 376.16129 360.76667 367.51613 397.80645 372.5 352.48387 352.36667 358.22581 354.06452 350.67857 375.29032 385.33333 381.06452 375.66667 373.09677 397.83871 375.93333 369.74194 361 376.83871
287 299.28571 302.93548 299.1 297.51613 300.16667 296.25806 310.54839 325.16667 310.93548 316.5 313.58065 316 311.5 316.45161 318.3 318.09677 320.83333 332.35484 340.96774 338.6 328.16129 333.86667 334.3871 331.03226 331.68966 345.90323 368.33333 360.77419 355.56667 359.41935 360.45161 365.86667 345.32258 346.73333 359.54839 355.96774 350.53571 375.09677 373.3 365.83871 352.33333 359.70968 398.83871 379.03333 365.12903 356.03333 365.96774 356.90323 359.64286 376 383.1 376.64516 371.16667 369.06452 400.70968 383.26667 377.09677 377.8 368.96774
298.58065 308.89286 313.58065 291.1 292.35484 292.26667 292.74194 312.77419 324.83333 318.80645 329.13333 328.29032 322.93548 329.78571 325.25806 312.56667 313.29032 314.03333 319.48387 340.51613 336.86667 343.77419 344.6 342.29032 337.06452 346.7931 355.87097 351.16667 361.22581 343.26667 343.45161 352.64516 358.1 350.87097 365.73333 359.74194 353.90323 362.71429 377.70968 356.23333 351.58065 339.13333 356.77419 389.96774 381.86667 375.35484 366.93333 375.35484 367.03226 374.5 392.3871 373.56667 361.25806 358.46667 367.3871 381.64516 383.3 390.54839 395.63333 387.45161
292.09677 301.42857 316.96774 283.3 276.83871 280.06667 272.35484 285.58065 303.06667 314.29032 322.4 327.87097 325.29032 332 321.3871 290.1 287 294.63333 297.67742 321.41935 311.4 325.77419 342.06667 339.64516 335.58065 348.55172 348.25806 328.4 329.93548 321.7 320.80645 329.19355 338.1 341 356.63333 364.09677 356.70968 360.14286 378.22581 336.6 330.32258 320.76667 329.6129 363.22581 362.36667 364.87097 367.73333 385.3871 369.29032 380.96429 388.74194 358.1 336 336.06667 340.41935 370.74194 358.93333 379.3871 394.76667 377.54839
295.90323 305.25 295.35484 253.73333 249.06452 248.2 245.41935 266.77419 282.03333 300.12903 311.4 317.03226 318.32258 315.25 301.74194 269.1 261.3871 275.9 273.80645 293.90323 279.76667 311.25806 325.4 330.87097 330.51613 339.86207 329.06452 298.83333 303.3871 301.9 296.6129 306.64516 313.73333 321.80645 341.53333 356.12903 354.16129 344.25 349.19355 301 302.06452 298.63333 307 322.12903 323.26667 341.6129 348.53333 367.22581 355.35484 363.67857 365.06452 329.16667 306.74194 303.23333 316.16129 339.09677 324 358.6129 392 383.41935
261.90323 255.53571 246.51613 218.66667 217.09677 214.33333 213.32258 218.93548 230.2 255.77419 265.86667 283.48387 282.25806 275.42857 260.74194 225.96667 219.16129 230.33333 234.48387 249.35484 237.86667 260.83871 278.53333 287.48387 280.90323 279.37931 274.83871 250.2 246.22581 254.76667 249.83871 251.16129 259 272.12903 287.06667 313.16129 318.96774 297.25 295.96774 260.63333 249.19355 255.8 263.93548 276.06452 268.23333 287.83871 297.5 321.67742 318.03226 312.82143 308.3871 280.8 262.77419 255.1 261.06452 274.70968 279.9 304.3871 322.73333 336.54839
216.45161 212.85714 206.74194 185.46667 178.93548 184.43333 186.70968 180.03226 202.23333 211.74194 223.73333 233.58065 231.93548 223.96429 217.09677 194.53333 189.12903 198.56667 200.80645 206.64516 201.6 222.12903 226.96667 234.06452 231.74194 229.27586 230.12903 218.6 211.32258 221.16667 216.58065 208.48387 221.3 228.87097 237.83333 255.32258 258.06452 240.60714 252.64516 221.26667 209.77419 216.93333 224.06452 232.35484 230.36667 245.22581 245.46667 261.09677 259.06452 255.78571 258.67742 241.2 223.09677 223.16667 222.96774 233.74194 229.56667 248.22581 258.66667 269.25806
171.06452 166.35714 162.32258 149.03333 143.58065 145.33333 150.83871 145.67742 160.5 168.41935 167.66667 183.29032 179.48387 173.96429 169.35484 159.13333 146.51613 158.86667 159.35484 163.22581 157.7 170.22581 173.26667 182.45161 179.32258 180.75862 185.54839 169.46667 168.03226 178.53333 166.45161 165.96774 165.66667 169.96774 181.23333 203.09677 194.48387 183.5 198.35484 172.3 169.19355 179.23333 174.19355 179.16129 182.43333 187.35484 184.5 202.87097 201.77419 195.14286 195.6129 190.9 170.83871 175.2 176.09677 185.6129 180.1 193.06452 196.46667 208.83871
Hourly Emergency Activity Tomograms
Average ED arrivals per hour 2010-2014
Tim
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rom
mid
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2359
0.2854595 0.2651758 0.2554873 0.2640201 0.244407 0.2233856 0.2223952 0.2089406 0.2179826 0.2311092 0.2377212 0.2685354 0.2488799 0.2264748 0.239322 0.238988 0.2192281 0.2105209 0.2079956 0.2013753 0.2012782 0.2251297 0.2287601 0.2511254 0.2592556 0.2473221 0.2492016 0.2364804 0.2162405 0.2025328 0.1905119 0.1928682 0.2105992 0.2603724 0.2616277 0.290396 0.2865634 0.2803311 0.2872508 0.2851638 0.2697019 0.2731508 0.2619633 0.248096 0.2867943 0.315318 0.3377418 0.3841623 0.4014823 0.367846 0.3604671 0.3519734 0.3276364 0.3450787 0.290527 0.2758993 0.3063084 0.3537208 0.3617192 0.3850094
0.2501425 0.2301059 0.2262425 0.2401474 0.218932 0.1984429 0.198091 0.1863249 0.1917953 0.2007584 0.2092806 0.2373452 0.2173539 0.2000775 0.209094 0.2121608 0.188055 0.1850465 0.1827029 0.173109 0.1795546 0.1955134 0.194576 0.2177807 0.2272727 0.211581 0.2184895 0.2090845 0.1877155 0.1789282 0.1654834 0.1657597 0.1815292 0.2249378 0.2262657 0.2551316 0.2476772 0.2458853 0.2547602 0.2545086 0.2340876 0.2410266 0.2278103 0.2212483 0.253143 0.2779851 0.2958211 0.341191 0.3587966 0.3260851 0.3272222 0.3198965 0.2988616 0.3113163 0.2588329 0.2466429 0.2743957 0.3107836 0.3173336 0.3406156
0.2134518 0.1935879 0.1924782 0.2090416 0.1882232 0.1696595 0.1703756 0.1613349 0.1618693 0.168711 0.1763769 0.2030632 0.1836904 0.1678066 0.1764998 0.1841923 0.1600603 0.1587368 0.1558706 0.149198 0.1522512 0.1627649 0.1650789 0.1828165 0.1922204 0.1791318 0.1850495 0.182454 0.1637163 0.1528638 0.1407931 0.1417091 0.1544906 0.1903485 0.190087 0.2138196 0.2125567 0.2081836 0.2200545 0.2176463 0.2002021 0.2080911 0.1971673 0.1901753 0.2167065 0.232565 0.2514077 0.3005609 0.3069307 0.2846476 0.2862861 0.2832714 0.2619964 0.2731585 0.2246942 0.2144371 0.239512 0.2685129 0.273553 0.2986986
0.1797165 0.1688975 0.1620737 0.1763489 0.1617209 0.1447083 0.1417597 0.1355546 0.1352383 0.1443085 0.1452558 0.1697903 0.1550307 0.1372225 0.1478781 0.1593277 0.1400103 0.134329 0.1310006 0.1270373 0.1285802 0.1377718 0.1403577 0.1575842 0.166017 0.1512013 0.1584499 0.1570099 0.1399827 0.1296961 0.1166374 0.1201581 0.1351483 0.1621236 0.1625853 0.1857263 0.1856295 0.1800825 0.1900227 0.1890528 0.1690679 0.1764813 0.165961 0.162212 0.1835744 0.1991113 0.218957 0.2648664 0.2636604 0.2489785 0.2517658 0.2470664 0.2251905 0.233258 0.1930507 0.1881885 0.2066245 0.2280668 0.2377803 0.2636381
0.1585022 0.1456506 0.1384261 0.1493882 0.1398339 0.1239147 0.1228123 0.1171698 0.1166481 0.1295669 0.1271787 0.1458833 0.1385761 0.124912 0.1306511 0.1416578 0.1228604 0.1146324 0.1133786 0.1097446 0.1118489 0.1182706 0.1179757 0.1393238 0.1428913 0.1350876 0.1403221 0.1355845 0.1241203 0.1097372 0.1040605 0.103402 0.1189175 0.14113 0.1428366 0.1676358 0.1646568 0.154837 0.1720315 0.1722069 0.1528337 0.1536702 0.1469059 0.1415178 0.1604137 0.1804485 0.1914351 0.2362751 0.2369217 0.2222157 0.2257641 0.2257507 0.1970266 0.2075128 0.1736872 0.161246 0.1819622 0.2044335 0.2132667 0.2381471
0.1394504 0.1268586 0.1243264 0.1375412 0.1272168 0.1111797 0.1067759 0.1061194 0.1055225 0.114365 0.1143978 0.1297629 0.1206275 0.1117413 0.1194868 0.1277793 0.1096049 0.1070509 0.0998325 0.0982587 0.1018241 0.1071968 0.1090264 0.1283212 0.1289475 0.1229163 0.1290387 0.1206033 0.1092281 0.1014401 0.0925661 0.0921653 0.1059645 0.1328192 0.1314907 0.1562081 0.1483511 0.146369 0.1588641 0.1573477 0.140617 0.140314 0.1333996 0.1276567 0.148276 0.1717374 0.1746546 0.2165862 0.218168 0.206584 0.2105632 0.2136343 0.184392 0.1968034 0.159134 0.1486243 0.1662843 0.1916335 0.1997211 0.219489
0.1310406 0.1226879 0.1169852 0.132068 0.1210762 0.1039404 0.1008233 0.1011911 0.097482 0.1104482 0.1098447 0.1228194 0.1152094 0.104787 0.1148046 0.1216146 0.1026393 0.0989217 0.0955524 0.0935799 0.0985442 0.1019616 0.102474 0.1251351 0.1251507 0.1170813 0.1246566 0.1197678 0.1046606 0.0950458 0.0914637 0.0873217 0.1041793 0.1294395 0.1287087 0.1518224 0.1403361 0.1446615 0.1552834 0.1562142 0.1381413 0.1361386 0.1303859 0.1256816 0.1502988 0.1756492 0.1774946 0.2133279 0.2160209 0.2112142 0.2041849 0.2062344 0.184947 0.1955948 0.1551538 0.1440922 0.1627381 0.193775 0.1949951 0.2206749
0.1428957 0.1267551 0.1276848 0.1466892 0.131763 0.1144899 0.1070938 0.1095715 0.1144189 0.1175028 0.1242852 0.1424761 0.1256568 0.1149822 0.1237441 0.1334326 0.1167738 0.1051433 0.1053562 0.1092414 0.1120885 0.1121162 0.1237531 0.1440146 0.1386227 0.1299647 0.1352293 0.1400716 0.1200188 0.1074109 0.1000846 0.1010265 0.1210416 0.1490006 0.1491638 0.1734803 0.1606817 0.1586897 0.1717995 0.1794123 0.1526111 0.1500157 0.1418725 0.1444132 0.1744482 0.1964116 0.2144199 0.2459054 0.2388902 0.2273085 0.2277228 0.2348349 0.2086442 0.2161099 0.1782379 0.1627094 0.1907694 0.2223626 0.2288265 0.2534617
0.2054694 0.1899099 0.1857584 0.2212135 0.194263 0.1666843 0.1562944 0.1654747 0.1792053 0.1742641 0.1841841 0.2091469 0.1887441 0.1740685 0.1778654 0.2014154 0.167446 0.1573741 0.1568574 0.1640247 0.1774648 0.1778166 0.1823011 0.2104735 0.2034997 0.1891796 0.1947292 0.2096217 0.1741348 0.1578141 0.1485589 0.1555136 0.1837609 0.2149056 0.2173934 0.2464225 0.2299626 0.2285137 0.2374423 0.2515476 0.2205013 0.2127229 0.203603 0.2088872 0.2541268 0.2766773 0.299373 0.3366504 0.3264202 0.3100574 0.2967247 0.3238903 0.2860367 0.2920879 0.2380098 0.228551 0.2753006 0.3049217 0.3127407 0.3448259
0.2951621 0.2816768 0.2772982 0.3146362 0.2846739 0.2549064 0.2352265 0.2475183 0.2602374 0.2592876 0.2739421 0.2983066 0.2727733 0.2589878 0.2658857 0.2968149 0.2537282 0.2412387 0.2397844 0.244158 0.2594431 0.2649721 0.2686074 0.3042499 0.2954193 0.2798525 0.2822243 0.3006489 0.261287 0.2357617 0.2223767 0.2329355 0.267522 0.3076643 0.3078468 0.3384109 0.3230095 0.3277979 0.3390024 0.3494785 0.3158805 0.3075285 0.2951344 0.3049734 0.3485212 0.3852014 0.4018086 0.4424193 0.4359604 0.4205626 0.4039576 0.4337093 0.3910458 0.3942503 0.3400732 0.3234059 0.3762368 0.4124449 0.4191879 0.4466773
0.3416001 0.3314441 0.3276361 0.3596763 0.3338403 0.3123435 0.2857091 0.3015024 0.307554 0.3126438 0.3148492 0.3447055 0.3235139 0.3074884 0.3178167 0.3466532 0.3125606 0.2946031 0.2948871 0.291561 0.3091227 0.3175559 0.3119063 0.3497611 0.3519191 0.3311852 0.3446763 0.3505924 0.3153627 0.2936271 0.2775462 0.2889719 0.3159846 0.3649913 0.3610028 0.3900246 0.3736898 0.3902767 0.4088054 0.4057602 0.3799367 0.3757005 0.364292 0.3697392 0.4058461 0.4444137 0.4610489 0.4998322 0.4996903 0.4889808 0.4771718 0.4989996 0.4599979 0.4662104 0.4105277 0.3951228 0.4306927 0.4759968 0.4786319 0.5022714
0.3564529 0.3395867 0.3431131 0.3649993 0.3458005 0.3283314 0.305457 0.3135341 0.316191 0.3260786 0.3192231 0.3563171 0.3389835 0.318523 0.3341324 0.3504724 0.3240743 0.3122015 0.3130114 0.3000573 0.3161977 0.3278111 0.3188829 0.3580522 0.3700987 0.3415805 0.362437 0.3568455 0.3323326 0.3122983 0.2974153 0.3022847 0.3248081 0.3783674 0.3780345 0.4039829 0.3961005 0.4116256 0.429543 0.4205934 0.4011978 0.3984312 0.3870977 0.3906402 0.4216698 0.4609468 0.4773562 0.5159215 0.5183158 0.5066818 0.5008736 0.5167372 0.4845965 0.491111 0.4395991 0.4191123 0.4486551 0.4981818 0.4989542 0.5184488
0.3499193 0.3300039 0.3334769 0.351145 0.3394975 0.3178842 0.3045113 0.3073277 0.3047045 0.3193837 0.310436 0.345595 0.3325896 0.3095551 0.327086 0.3374961 0.3203043 0.307002 0.3106335 0.2927889 0.3033603 0.3213901 0.3107657 0.3481644 0.359882 0.3359105 0.3563696 0.3468107 0.3264256 0.3068548 0.2937584 0.3004445 0.3162634 0.3693222 0.3689695 0.3925035 0.3902488 0.4044212 0.4223131 0.4152538 0.3994574 0.3993953 0.3882855 0.3850491 0.4161194 0.4536577 0.4749082 0.5077009 0.5209157 0.4992575 0.5003332 0.512511 0.4852403 0.4946097 0.4447059 0.4244507 0.44699 0.4978737 0.4936357 0.5163337
0.338677 0.3203049 0.3220761 0.3367234 0.3278264 0.3076591 0.2946884 0.2940077 0.2908212 0.3056234 0.2954304 0.3313189 0.320604 0.2971829 0.3145417 0.323769 0.3060781 0.2963037 0.2974194 0.2798839 0.2884795 0.3079309 0.2986916 0.3338337 0.3455753 0.3238693 0.3417605 0.3351456 0.3170498 0.2986144 0.2876062 0.2935128 0.306166 0.3566269 0.3581881 0.3819511 0.3756982 0.3906259 0.403014 0.4008717 0.3914185 0.3898509 0.3826407 0.3752221 0.4009815 0.4375491 0.4646519 0.4932024 0.5126144 0.489822 0.4889405 0.496515 0.4765827 0.4849549 0.435916 0.4204416 0.4396642 0.4852424 0.4856017 0.5042714
0.3334044 0.3139315 0.314152 0.3299644 0.3236616 0.3024145 0.2934392 0.2869124 0.2835868 0.3000535 0.2912455 0.3232706 0.315288 0.2881122 0.30536 0.3163953 0.301999 0.2889882 0.293059 0.2781596 0.2828023 0.2965879 0.2932689 0.3234654 0.3378611 0.3141506 0.3336767 0.3267266 0.3129979 0.2934843 0.2823635 0.2881831 0.3035554 0.3496886 0.3526607 0.3768175 0.3678838 0.3848923 0.3941193 0.393795 0.3848997 0.3807518 0.3753601 0.3705056 0.3971277 0.4320712 0.4573791 0.4847741 0.5061484 0.4807102 0.4779334 0.4902113 0.4684042 0.4764657 0.4317039 0.4135001 0.4346512 0.4746143 0.4769114 0.49178
0.3301024 0.3070576 0.3096412 0.3296973 0.3197452 0.3006214 0.2911961 0.2863875 0.2826201 0.2966821 0.2917769 0.3192672 0.3097414 0.2824294 0.3005339 0.314713 0.298641 0.2881811 0.2881288 0.274943 0.2770828 0.2909441 0.2898969 0.3194151 0.330385 0.3107005 0.3310229 0.3246958 0.3124987 0.2912772 0.2802893 0.2832336 0.3048118 0.3426774 0.3491084 0.3729028 0.3641618 0.3786673 0.3882388 0.3907375 0.3841194 0.3747347 0.3721342 0.3662615 0.3947479 0.4255247 0.4524275 0.4771149 0.5 0.4711746 0.4706193 0.4832494 0.462372 0.47141 0.4258122 0.408025 0.4253864 0.4677691 0.4703903 0.4852985
0.3209731 0.3026347 0.3057632 0.3234314 0.3148882 0.2966286 0.2901271 0.28358 0.2791529 0.289073 0.2853237 0.3174435 0.3007882 0.2787645 0.2979311 0.3112413 0.2960767 0.2852724 0.284614 0.2704732 0.2767257 0.2847043 0.2894994 0.3150945 0.3259442 0.3054961 0.3276449 0.3225058 0.3064455 0.2849555 0.2744527 0.2789956 0.3037095 0.3369573 0.3465643 0.3702278 0.3623721 0.3738346 0.3849178 0.3856778 0.3768828 0.370776 0.3626236 0.3593783 0.392102 0.419898 0.4439051 0.4734813 0.4930001 0.4610352 0.4646341 0.4752402 0.4540935 0.4635872 0.4197675 0.4005916 0.4210782 0.4624468 0.4605708 0.4771172
0.3192533 0.3043571 0.3074147 0.3253995 0.317411 0.2920992 0.2875527 0.2863126 0.2808992 0.2904146 0.2889406 0.31823 0.2995944 0.2819105 0.2957675 0.3118457 0.2982766 0.2826594 0.2802863 0.2703631 0.2799876 0.2869574 0.2914928 0.3187132 0.3263718 0.3108777 0.3259078 0.3249656 0.3052782 0.2818609 0.2680858 0.2768657 0.3035639 0.33573 0.3467349 0.3740743 0.3596339 0.3691514 0.3827051 0.3836824 0.3756767 0.3676905 0.3597315 0.358906 0.391258 0.4178705 0.4398636 0.4718885 0.4878076 0.4561017 0.4613565 0.4734847 0.4488618 0.4548806 0.4105583 0.3982718 0.417511 0.4574023 0.4577121 0.4749797
0.3230739 0.3135533 0.3145968 0.3281331 0.3187495 0.2912637 0.2862342 0.2861009 0.2851694 0.2903209 0.2960461 0.3210215 0.3006509 0.2845014 0.3056138 0.3151771 0.2955704 0.2795002 0.27945 0.2734538 0.2847883 0.2941234 0.2981828 0.3243917 0.3270199 0.3158159 0.326875 0.3261844 0.3013454 0.2756542 0.2691539 0.2771605 0.3065685 0.3426647 0.3491175 0.3770393 0.3607909 0.3693477 0.3835451 0.3820298 0.3718276 0.3617944 0.3543025 0.3547513 0.3898463 0.4177353 0.442384 0.4729678 0.4854539 0.4551541 0.4606445 0.4687901 0.445561 0.4471575 0.4082269 0.3946337 0.4174205 0.4599717 0.4631734 0.4708377
0.3321367 0.3263801 0.3229189 0.3329773 0.3179725 0.2877319 0.2860484 0.2860037 0.2892252 0.2977923 0.3067541 0.3296695 0.3061006 0.2966172 0.3156736 0.3159408 0.2926529 0.2789461 0.2767344 0.2776476 0.2910308 0.3050712 0.3066536 0.3287183 0.3337464 0.3249557 0.332039 0.3229516 0.3032825 0.272029 0.2678365 0.2770842 0.3080759 0.3457985 0.3553916 0.3784385 0.3635499 0.3754388 0.3849857 0.3788627 0.3660642 0.3539484 0.3531066 0.3495767 0.3920092 0.4237695 0.4481103 0.4781512 0.490734 0.4628023 0.4672293 0.4621053 0.4377066 0.4438622 0.4007923 0.3890687 0.4186393 0.4639105 0.4692184 0.4807331
0.3459472 0.3426052 0.3386309 0.3438698 0.3214973 0.2928471 0.2897186 0.2887873 0.2940447 0.3093855 0.3187402 0.3448586 0.3237189 0.3124793 0.3250188 0.318647 0.2942591 0.284805 0.276711 0.2815246 0.2920073 0.3118707 0.3193216 0.3379803 0.3478003 0.3389546 0.3432528 0.3186802 0.3040364 0.2731438 0.2687003 0.2772275 0.3084681 0.355428 0.3679097 0.3905774 0.3745647 0.3882129 0.3930939 0.3829673 0.3636166 0.3564354 0.3539285 0.3471802 0.3939712 0.4322032 0.4517137 0.4897368 0.4960075 0.4765534 0.474892 0.459646 0.4384999 0.4431294 0.399918 0.3893186 0.4202973 0.471411 0.4785803 0.4887188
0.3616743 0.3551346 0.3418276 0.3384762 0.3191057 0.2953176 0.2861227 0.2876745 0.2925518 0.3131509 0.3221485 0.3532803 0.3296009 0.3166718 0.3274044 0.3178205 0.29203 0.2893338 0.2720731 0.2781904 0.2870202 0.3159792 0.3234065 0.3487654 0.3544586 0.3438802 0.3425603 0.3143998 0.2993259 0.2702684 0.2646634 0.2757727 0.3073211 0.3562293 0.3668521 0.3954733 0.3831951 0.3896609 0.3915154 0.3740286 0.3574143 0.3513895 0.3476296 0.3351647 0.3868466 0.4285049 0.4522968 0.4916733 0.5009214 0.4793526 0.4724395 0.4513073 0.4294374 0.4379892 0.396099 0.3784639 0.4102492 0.4662671 0.4820358 0.4909906
0.3565296 0.3384595 0.3238562 0.3265486 0.3088039 0.2810655 0.2750506 0.2711974 0.2748427 0.2978052 0.3101671 0.3414837 0.3174316 0.3035905 0.3075601 0.3017032 0.2759541 0.2679806 0.2580944 0.2581118 0.2678814 0.297037 0.3065763 0.3337588 0.336414 0.3224291 0.3231593 0.2956297 0.2803524 0.2540126 0.2476693 0.2590863 0.2836678 0.3393626 0.3473665 0.3780178 0.3683211 0.3693923 0.3701236 0.356428 0.3363424 0.3360979 0.3283357 0.3110573 0.3621952 0.4049632 0.4310217 0.4708592 0.4846247 0.4587495 0.4465161 0.4327048 0.4072004 0.4155243 0.3699116 0.3550572 0.3869472 0.4449363 0.4577055 0.4745376
0.3278258 0.3088246 0.2990639 0.3033716 0.2866333 0.2585486 0.2558644 0.246095 0.2514595 0.2711172 0.2815315 0.3132602 0.2904822 0.2686679 0.2816994 0.2753887 0.2518592 0.2420165 0.2379863 0.2329666 0.2379498 0.2697037 0.2735774 0.2999655 0.3015813 0.2899819 0.2905009 0.2701183 0.2540678 0.2327991 0.2237189 0.2319672 0.2536097 0.3090019 0.3113706 0.3423519 0.3363258 0.3318553 0.3371106 0.3256522 0.3097821 0.3117431 0.3002419 0.2835759 0.3305557 0.3695128 0.3911884 0.4350939 0.4508741 0.4198636 0.4087612 0.4003538 0.3749645 0.3846616 0.3365787 0.3174403 0.351381 0.4095754 0.4176883 0.4376894
Effect of NEAT intervention 2012 on
patients leaving ED within 4 hours
2012 NEAT implementation
22
00
1
2
06
00
MN
Forecasting
Mean presentations to NSW EDs at 11am
Proportion of admitted patients leaving ED
M T W T F S S
MN-1 0.28 0.32 0.32 0.33 0.33 0.33 0.29
1-2 0.29 0.32 0.32 0.33 0.33 0.33 0.29
2-3 0.27 0.31 0.31 0.31 0.32 0.31 0.27
3-4 0.27 0.31 0.31 0.31 0.31 0.3 0.26
4-5 0.27 0.31 0.31 0.31 0.31 0.3 0.26
5-6 0.28 0.31 0.32 0.33 0.32 0.31 0.27
6-7 0.25 0.28 0.28 0.29 0.28 0.27 0.23
7-8 0.26 0.27 0.27 0.27 0.28 0.25 0.23
8-9 0.3 0.33 0.33 0.33 0.33 0.3 0.27
9-10 0.23 0.26 0.26 0.26 0.26 0.24 0.21
10-11 0.23 0.26 0.27 0.26 0.26 0.22 0.18
11-12 0.25 0.29 0.29 0.29 0.28 0.22 0.19
12-13 0.26 0.28 0.29 0.28 0.28 0.21 0.19
13-14 0.26 0.29 0.28 0.28 0.28 0.22 0.2
14-15 0.27 0.29 0.29 0.29 0.28 0.23 0.21
15-16 0.26 0.28 0.28 0.28 0.27 0.22 0.21
16-17 0.28 0.29 0.29 0.29 0.29 0.23 0.22
17-18 0.28 0.29 0.29 0.29 0.29 0.22 0.21
18-19 0.28 0.3 0.29 0.3 0.3 0.23 0.22
19-20 0.3 0.31 0.31 0.31 0.31 0.24 0.23
20-21 0.31 0.31 0.31 0.31 0.32 0.26 0.24
21-22 0.27 0.27 0.27 0.27 0.28 0.23 0.21
22-23 0.27 0.27 0.27 0.27 0.28 0.25 0.22
23-MN 0.28 0.28 0.28 0.28 0.29 0.26 0.24
WORKING TOWARDS
Implementation and evaluation of a decision support tool to
assist with disposition decisions in EDs across SLHD
Regression analysis
Machine learning
Interface implementation
MoH Translational Research Grant 2016
Odds Ratio Estimates and Profile-Likelihood
Confidence Intervals
Effect Estimate
95%
Confidence
Limits age_cat10 2 vs 1 1.206 1.185 1.227
age_cat10 3 vs 1 1.85 1.818 1.883
age_cat10 4 vs 1 3.322 3.264 3.382
age_cat10 5 vs 1 6.034 5.917 6.153
Ambulance 1 vs 0 2.169 2.151 2.186
triage_category 1 vs 5 88.092 83.05
1
93.61
9
triage_category 2 vs 5 20.044 19.58
1
20.53
4
triage_category 3 vs 5 8.034 7.863 8.216
triage_category 4 vs 5 3.018 2.954 3.087
flg7days 1 vs 0 1.108 1.093 1.122
flgadmit30 1 vs 0 1.868 1.841 1.895
business_hours 1 vs 0 1.234 1.221 1.247
business_hours 2 vs 0 1.013 1.001 1.024
present_cat_new 1 vs 3 1.389 1.369 1.409
present_cat_new 2 vs 3 0.493 0.485 0.502
present_cat_new 4 vs 3 1.916 1.871 1.962
present_cat_new 5 vs 3 0.474 0.467 0.481
present_cat_new 6 vs 3 1.016 0.997 1.036
present_cat_new 9 vs 3 0.566 0.556 0.575
present_cat_new 10 vs 3 0.783 0.769 0.796
present_cat_new 11 vs 3 0.72 0.706 0.735
present_cat_new 12 vs 3 0.741 0.715 0.767
present_cat_new 13 vs 3 0.312 0.304 0.32
present_cat_new 14 vs 3 0.562 0.545 0.579
present_cat_new 15 vs 3 0.85 0.831 0.869
present_cat_new 16 vs 3 1.215 1.066 1.385
present_cat_new 17 vs 3 0.97 0.915 1.028
present_cat_new 18 vs 3 0.576 0.559 0.593
present_cat_new 19 vs 3 0.739 0.721 0.757
present_cat_new 20 vs 3 2.711 2.409 3.057
Regression modelling
Clinical Decision support tools
Driving quality in Emergency Departments
Understanding need for better data systems
Better understanding of population based trends in demand
Surveillance
Better systems and models of care, more informed policy
interventions and resource management
Improved clinical decision making
Recommendations
Only one diagnostic coding system
Limited standard fields of presenting problem field with no
free text
Groups of common diagnostic categories
Coding of clinical notes