Article Text
PDF
Abstract
Background Growing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences in the utilisation of low-acuity ED visits between culturally and linguistically diverse (CaLD) migrants and English-speaking background (ESB) population.
Methods A study based on a cross-sectional survey of individuals aged 45 or over linked to routinely collected ED visit records in New South Wales. We employed a negative binomial regression model to compare the number of yearly low-acuity ED visits between individuals from ESB and CaLD backgrounds after adjusting for relevant health-related and sociodemographic characteristics.
Results We analysed 227 681 individuals with a mean age of 61, two-thirds of whom came from an ESB. Among individuals with a CaLD background, only those born in Australia had comparable rates of low-acuity ED visits as those with an ESB. In contrast, individuals with CaLD backgrounds who were born overseas were significantly less likely to make low-acuity visits to the ED compared with those from an ESB irrespective of year of arrival—for those who had migrated less than 20 years ago (relative risk (RR) 0.72, 95% CI 0.62 to 0.83) and those who migrated more than 20 years ago (RR 0.91, 95% CI 0.88 to 0.95).
Conclusion Foreign-born migrants aged 45 and over from CaLD backgrounds tend to have the lowest rates of low-acuity ED visits, particularly those who migrated more recently indicating low-acuity visits by CaLD patients are unlikely to contribute to ED crowding.
- utilisation
- health service accessibility
- Models, Statistical
- Observational Study
Data availability statement
Data may be obtained from a third party and are not publicly available. This project used linked data from various data sources.
Statistics from Altmetric.com
Data availability statement
Data may be obtained from a third party and are not publicly available. This project used linked data from various data sources.
Footnotes
Handling editor Liza Keating
X @ben_hr, @anuragunsw
Contributors AS conceptualised the study. FA-D and AS undertook quantitative analysis and wrote the paper. AYMAK provided cleaned data set and comments on the empirical results. MB, MH, BH-R and DPC provided input in the revision of first draft. AS is the guarantor of the manuscript.
Funding This research project is partly funded by the Chilean National Scholarship Program for Graduate Studies (Becas Chile). There are no competing interests.
Disclaimer The authors state that the views expressed in the submitted article are their own and not an official position of the institution.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.