When we’re seriously sick or injured, we wish to have the ability to access care quickly in Australian hospital emergency departments (EDs). But most of us seek care within the ED. It went away 7.4 million In 2014–15 9.1 million In 2024–25. And the system is struggling to manage.
EDs have gotten overcrowded and patients are staying in EDs for much longer. About 10% of patents are waiting for patient beds 19 or more hours spent in ed – waited six hours longer than 4 years ago.
About 10% of patients discharged home spent eight or more hours within the ED — nearly two hours longer than 4 years ago.
Improving access to patient beds from the ED is a vital a part of reducing ED congestion. But so are strategies to scale back the variety of patients presenting to the ED.
Since the May elections, the federal government has been Spanning its extended network Urgent care clinics to scale back ED presentations for patients with urgent but non-life threatening conditions.
But how are they working? And how do they slot in with other services which have the identical goal of keeping Australians out of hospital?
What is currently in place?
There are three free services to divert patients who don’t must go to hospital to more appropriate settings.
Health Direct (called nurse on call in Victoria) is one The 24/7 phone advice service is manned by nurses And has been running since 2006. It gives callers health advice, including whether or not they should see a GP or go to the ED.
Urgent care clinics a A network of around 90 health servicesprimarily staffed by GPS, where patients can walk in without an appointment and get treatment for urgent but non-life-threatening conditions. They are open day by day from early morning until late at night and might provide diagnostic services resembling blood tests and X-rays.
Virtual ED services Provide consultations via video link with expert ED physicians and other physicians. In the past five years, virtual ED has been established in Victoria, South Australia, Queensland, Western Australia and New South Wales. Health providers can call virtual ED services for advice on where to refer a patient.
We know little or no about their quality and safety
There is little published evidence to guage these three services, although necessary evaluations Urgent care clinics And Virtual aids In progress.
Interim evaluation of an urgent care clinic reported no data on safety and quality, but stated that a clinical evaluation was carried out to verify their safety and readiness to work before opening.
one Evaluation of a virtual ad service in New Zealand reported similar seven-day readmission rates for virtual and traditional EDs. This signifies that similar proportions of patients must return for further care, suggesting that patients receive similar care in each sorts of EDs.
Do they reduce pressure on hospitals?
We need to trust patients who would otherwise present within the ED are using these services they usually are an efficient use of the health budget.
Initial assessment of the urgent care clinic found 46 percent of urgent care clinic patients would have otherwise presented to the ED. About 5% of patients using an urgent care center were referred to the ED.
Urgent care centers subsequently avoided 4 out of ten ED presentations and resulted in a small reduction in health service costs.
Data from Virtual ED Show 30% of patients in Queensland and Victoria are then referred to Physical Aid. This suggests that the virtual ED manages patients with more serious conditions than an urgent care clinic.
one Economic evaluation of an initial virtual ED service A small reduction in health service costs in Victoria was also estimated, assuming that every one patients would otherwise have been presented to the ED, but none were admitted. Other scenarios produced larger cost estimates.
Published data related to Health Direct found that 69% of patients attended the ED and 65% consulted a physician if advised. One review found that health direction led to “modest but significant” reductions in ED use and after-hours GP visits.
How can these services be improved?
We may improve the Services, specifically, how the Services integrate with one another.
Half of patients using an urgent care clinic said they’d have If they did not use the clinic, they saw the GP. If patients had higher access to GPS, it will unencumber the power for more patients who present within the ED to be treated in an urgent care clinic.
Most virtual EDs are relatively small-scale, except in Victoria, where virtual ED takes over More than 700 calls per day. This suggests that there’s scope for scaling up virtual ED, which should lower average costs.
A virtual ED can refer patients to urgent care centers to access diagnostic services, and urgent care centers can call a virtual ED for expert advice. Research is required to guage the effectiveness of linkages between urgent care centers and virtual EDs.
Health Direct Patients refers to GPs, Urgent Care Clinics, EDs and Virtual EDs. We need more research to evaluate the adequacy of those referrals to discover opportunities to enhance utilization of those various health services.
Although the three services have overlapping patient groups, they’re currently being developed independently. Instead, we want to develop, implement and evaluate a plan for the integrated delivery of those services.
Each service might help keep Australians out of hospital, but an integrated approach will cost greater than the sum of individual services.