Increase in demand for emergency service subject to ‘significant non- demographic influence’

The growth in demand for unscheduled care (USC) in Irish hospitals exceeds demand forecast by population growth and changing age structure, according to a new Irish report. The report, which is titled A Special Analysis of Recent Trends in Demand for Unscheduled Care, was conducted by the HSE’s Health Intelligence Unit, following a request from the Special Delivery Unit and Acute Hospitals Division for an analysis of demand for emergency services in the context of winter planning for the 2018/2019 period.

According to the report, which was obtained by the Medical Independent through Freedom of Information law, the absolute annual growth in demand for emergency department (ED) presentations was 4.6 per cent, which is in excess of the OECD average.

However, the authors note this is “not out of step with relative comparators” since annual growth of 5-10 per cent has been observed in Germany, Belgium, UK and New Zealand.

The authors note that a  “key feature of the growth in demand for USC observed across the period is that it exceeds demand forecast by population growth and changing age structure”.

This is consistent with the findings that self-referral has increased relative to other referral sources across the study period, according to the report. “While demographic ageing is a key concern for USC planning, the peak in age-specific utilisation of ED and high non-demographic pressure among older adolescents and younger adults would benefit from further study since this subgroup are heavy users of ED in absolute terms, and it is likely that some of this demand is amenable to intervention” the report concludes.

This analysis examined data from January to August 2018 and compared trends with the same period in 2016.

Hospitals included in the study were: Beaumont Hospital, Dublin; Cork University Hospital; University Hospital Galway; University Hospital Limerick; Mater Misericordiae University Hospital, Dublin;  Our Lady of Lourdes Hospital, Drogheda; St James’s Hospital, Dublin; Tallaght University Hospital; and St Vincent’s University Hospital, Dublin.