Emergency department presentations

Emergency departments (ED) are an essential component of Australia’s health care system. Many of Australia’s public hospitals have purpose-built EDs, staffed 24 hours a day, providing care for patients with heart, stroke or vascular disease who require urgent medical, surgical or other attention.

There were 327,000 presentations to Australian public hospital EDs with a principal diagnosis of cardiovascular disease (CVD) in 2019–20—a rate of 1,300 presentations per 100,000 population.

The triage category indicates the urgency of the patient’s need for care. Of ED presentations with a principal diagnosis of CVD in 2019–20, 14,700 (4.5%) were triaged as ‘resuscitation’ and needed immediate care, 139,900 (43%) were ‘emergency’ (within 10 minutes), 124,600 (38%) were ‘urgent’ (within 30 minutes), 43,200 (13%) were ‘semi-urgent’ (within 60 minutes) and 4,600 (1.4%) were ‘non-urgent’ (within 120 minutes) (AIHW 2020).

Almost two-thirds (64%) of ED presentations with a principal diagnosis of CVD were subsequently admitted to the hospital they presented to in 2019–20, with another 29% departing without being admitted or referred, and 5.6% referred to another hospital for admission.

In addition to ED presentations with a principal diagnosis of CVD, there were 353,000 ED presentations with symptoms of ‘Pain in throat and chest’ (ICD-10-AM R07) in 2019–20. Of these, 153,000 (43%) were subsequently admitted to hospital for further investigation and treatment (AIHW 2020).

Age and sex

In 2019–20:

  • there were 174,000 male and 153,000 female presentations to Australian public hospital ED with a principal diagnosis of CVD
  • the age-standardised male rate of presentation was 1.3 times as high as the female rate (1,248 and 988 per 100,000 population)
  • more than half of presentations (184,000, or 56%) were among people aged 65 and over
  • presentation rates increased with age, to be highest among males and females aged 85 and over (9,100 and 7,900 per 100,000 population)―more than twice as high as age 65–74 (3,600 and 2,600 per 100,000 population)
  • at age 55–64, the male rate of presentation was 1.6 times as high as the female rate (2,200 and 1,400 per 100,000 population). At age 25–34, the female rate of presentation was 1.1 times as high as the male rate (374 and 350 per 100,000 population).

Variation among population groups

In 2019–20:

  • Indigenous people presented to EDs with a principal diagnosis of CVD at 2.3 times the rate of non-Indigenous people (age-standardised rates of 2,500 and 1,100 per 100,000 population)
  • rates increased with remoteness, being 1.6 times as high in Remote/very remote areas compared to Major cities (age-standardised rates of 1,600 and 1,000 per 100,000 population)
  • rates for people living in the lowest socioeconomic areas were 1.9 times as high as for people in highest socioeconomic areas (age-standardised rates of 1,500 and 760 per 100,000 population).

Figure 1: Emergency Department presentation rates, principal diagnosis, by age group, 2019–20

The line chart shows the increasing rate of Emergency Department presentations for CVD with age in 2018–19, most notably for heart failure and stroke from age 65–74.

Principal diagnosis

In 2019–20:

  • there were 73,800 ED presentations with a principal diagnosis of coronary heart disease (CHD), 42,400 with atrial fibrillation (AF), 38,700 with stroke, 33,400 with heart failure, and 7,800 with peripheral arterial disease (PAD)
  • the age-standardised rate of ED presentation by principal diagnosis for males compared to females varied, from 1.3 times as high for AF, 1.4 for stroke, 1.7 for CHD and 2.1 times for PAD
  • Indigenous Australians had much higher age-standardised ED presentation rates than non-Indigenous people for CHD and for heart failure (both 3.4 times as high)
  • people living in the lowest socioeconomic areas had much higher age-standardised ED presentation rates than people in the highest socioeconomic areas for CHD (2.7 times as high), heart failure and PAD (both 2.5 times as high)
  • the rate of admission to hospital following ED presentation varied by principal diagnosis, from 63% for AF presentations, to 78% for CHD presentations, and 83% for stroke and for heart failure presentations.

Reference

AIHW 2020. My Hospitals. Emergency department care. Emergency department care 2019-20 data tables. Table 4.6–4.10. Canberra: AIHW.