Aboriginal and Torres Strait Islander people constitute 43 per cent of all emergency department (ED) presentations in the Northern Territory, a report reveals, despite representing just 26 per cent of its population.
The Australasian College for Emergency Medicine's (ACEM) inaugural State of Emergency Report 2022, to be released today, has detailed the strain the territory's six public EDs are under.
The report found that between 2020 and 2021 there were 177,600 presentations, a 15-per cent increase from 2016, with the territory's population growing by 1 per cent in that time.
"At 746 presentations per 1,000 population, the NT had the highest presentation rate per 1,000 population across all states and territories," the report stated.
EDs included those at the Alice Springs, Gove, Katherine, Palmerston Regional, Royal Darwin, and Tennant Creek hospitals.
The college's president-elect Dr Stephen Gourley said the findings were concerning but expected.
"That's a reflection of what we call the social determinants of health," he said.
"People that have poor access to good food, poor living conditions … they go on to have more chronic illnesses, and will need to access care more frequently than people that are able to access primary health care."
Dr Gourley said changes had been made over the years to reduce the health care gap.
"Where we really need to focus our energy … is [on] those basic health care needs," he said.
"We need to get the housing, education, diets, access to good and affordable primary healthcare [right]."
Hospital system under strain
According to the report, people presenting with mental health or behaviour problems increased from 18 per day in 2016-17 to 21 per day in 2020-21. Those cases accounted for 4 per cent of all ED presentations.
The report also stated that 6 per cent of all people coming to ED either did not wait for treatment, or left at their own risk in 2020-21, a 17-per cent decrease from 2016-17.
"Patients in Northern Territory are waiting longer to access care and particularly [in] getting an inpatient bed," Dr Gourley said.
"That means that there are more people that are sitting, taking up a bed in the emergency department when they should be having the care in [an] inpatient ward bed."
Dr Gourley said there had been a surge in presentations as people returned to normal activities after several years of restrictions due to the COVID-19 pandemic.
"We are setting new records for the number of people seeking care. It's exceeding what we had before COVID," he said.
"We're seeing all the usual things that happen when people are out and about. We haven't seen the flu for several years and flu has come back with a real vengeance."
Longer wait times
Dr Gourley said COVID had delayed people's care.
"We're seeing later diagnosis of cancers because people haven't had their screening done as they should have because of the COVID restrictions," he said.
Subsequently, patients who needed to be admitted were staying longer in ED with an average wait time of nearly 14 hours.
"The hospital system hasn't kept up with the population growth and also the increasing demand for care," Dr Gourley said.
He said the problem had been 20 years in the making due to people living longer with chronic illnesses and requiring specialised care.
Dr Gourley added that the current health care model was outdated.
"Looking at the aged care sector, we know that there's a lot of people taking up an acute care bed who simply can't get into an aged care home," he said.
"Looking at the NDIS disability services sector, again, people [are] sitting in hospitals taking up an acute care bed, just because they can't access services."
