- ED presentations between 2020–21 and 2021–22, remained relatively stable, decreasing by 0.2% overall.
- In the previous year, between 2019–20 and 2020–21, ED presentations increased by 6.9%, representing a rebound following low growth in the early stages of the pandemic.
- With the initial outbreak of COVID-19 in 2019–20, the number of ED presentations decreased by 1.4% compared to 2018–19.
- In the years preceding COVID-19, between 2014–15 and 2018–19, the number of presentations to public hospital EDs increased by 3.2% on average each year.
Impact of COVID-19 on overall ED activity
In 2021–22, average daily presentations to ED dropped twice due to COVID-19 waves, mutations and associated lockdowns.
- Between June 2021 and September 2021, the average daily ED presentations dropped from 25,000 to 23,200.
- Following this, the average daily ED presentations increased to a peak of 26,000 in December 2021 dropping to 22,500 in February 2022, which was lower than the corresponding period in 2018–19.
From February 2022, the average daily presentations to ED increased steadily to 24,300 in June 2022.
In 2020–21, average daily presentations to ED increased steadily from 21,400 in July 2020 to 25,100 in June 2021 which was higher than the corresponding period in 2018–19 for all months except July 2020 and September 2020. Despite this return to pre COVID-19 ED activity at a national level, ED presentations in Victoria decreased from July to August 2020, potentially due to an increase of local COVID-19 cases between June and September 2020, and associated restrictions.
Prior to the outbreak of COVID-19 in Australia, the average daily presentations to emergency departments steadily increased from 21,600 in July 2018 to 23,900 in February 2020, an average increase of 0.56% per month. In March 2020, the average daily presentations to ED were 23,000 which then dropped to 17,000 in April 2020, a substantial decrease of 26% in a single month. The average daily ED presentations then steadily increased to 19,100 in May 2020 and 21,500 in June 2020, which was still 8.6% lower than the corresponding period in 2018–19.
Urgency of care
When a patient presents to the ED an experienced registered nurse or medical practitioner allocates them a triage category. This indicates the urgency of the patient’s need for medical and nursing care.
During outbreaks of COVID-19, the proportion of ED presentations with chronic or minor symptoms and for whom treatment can be delayed up to 2 hours increased.
- In the early months of 2021–22, that is July 2021 to August 2021, the proportion of ED presentations that were assigned a triage category of Non-urgent ranged between 10% and 12%. Additionally, in December 2021, this proportion peaked to 13% which was then followed by a gradual decrease to 7% by June 2022.
- In 2020–21, variation was observed due to COVID-19 outbreaks and the associated lockdowns, where non-urgent presentations accounted for between 9% and 13% of presentations.
In the months between July 2019 and February 2020, the average daily Non-urgent presentations accounted for 7–8% of average daily ED presentations. In March 2020, Non-urgent presentations increased and accounted for 13% of the average daily number of ED presentations. Non-urgent ED presentations then declined to around 10–11% between April to June 2020.
COVID-19 changes the types of ED presentations
The outbreak of COVID‑19 infections and associated national and jurisdiction-based measures influenced the types of presentation to emergency departments in Australia from February 2020.
Over the period from February 2020 to June 2022, the average daily presentations with a principal diagnosis of COVID-19 (including emergency use codes U07.1 and U07.2):
- continually rose from just 1 in February 2020 to 702 in August 2020, and then decreased to 263 in October 2020
- following another spike of 433 in December 2020, it fell to 135 in April 2021
- in 2021–22, average daily presentations with a COVID-19 diagnosis rose again to a peak of 739 in August 2021 and then fell to a low of 261 in November 2021
- the highest peak of 1,681 was seen in January 2022, followed by a sharp fall to 545 in February 2022, which increased again to 801 in April 2022 and then decreased to 469 in June 2022.
Over the period from February 2020 to June 2022:
- The average daily number of presentation with a diagnosis related to Injury decreased from 4,567 in February 2020 to 3,316 in April 2020. In 2021–22, the average daily presentation fell from 4,795 in December 2021 to 4,116 in January 2022
- The decrease in the number of Injury related presentations during the early months of 2020 and 2022 is likely influenced by the increased restrictions on public and social gatherings and activities, including sporting events and travel restrictions, and availability of other health facilities.
- The average daily number of presentations with a principal diagnosis in the Respiratory body system group increased from 2,055 in February 2020 to 2,881 in March 2020. Respiratory presentations decreased from 2,430 in June 2021 to a low of 1,326 in February 2022 (at a time when COVID-19 diagnoses peaked) and then rose 3,162 in June 2022.
- The average daily number of presentations with a principal diagnosis in the Infectious body system group rose sharply from 1,094 in February 2020 to 1,762 in March 2020. Presentations then dropped to 646 in May 2020, largely replaced by COVID-19 related presentations. This could be due to the use of the viral illness, unspecified code during this period.
- From July 2020, the Infectious presentations fluctuated, with sharp increases occurring in 2020–21 and 2021–22 that may relate to an increase in ED activity in a number of jurisdictions and again an increased use of the code viral illness, unspecified.