The Doctor Will See You Now: Wait Times in Emergency Departments

More than  eight million patients visited public emergency departments across Australia last year, according to a recently published report from the Australian Institute of Health and Welfare (AIHW).

That is approximately 23,000 patients on average per day, which is an increase of 4.2% from the 2017-18 period.

The AIHW said some of the most common diagnoses of those in emergency last year included injury (such as fractures and burns), poisoning, infectious and parasitic diseases and mental and behavioural disorders.

So, for those suffering with these or other conditions, how long did it take for them to receive care in emergency, and how did wait times differ depending on where they were or the level of care they required? Let’s take a closer look.

emergency wait line
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How long did patients wait in emergency in 2018-19?

The AIHW broke down emergency wait time statistics into two categories of measurement: median waiting time and 90th percentile waiting time.

1. Median waiting time

The “median waiting time” is the time within which half of all patients received emergency clinical care in Australian public hospitals.

In 2018-19, the national median emergency wait time in Australian public hospitals was 19 minutes.

The AIHW said the above national average is consistent with the median waiting time for 2017-18, and similar to waiting times in 2014-15.

The only state in Australia that recorded a shorter median wait time than the national average last year was New South Wales, at 15 minutes.

On the other end of the scale, the AIHW found patients had to wait longer for emergency care in Tasmania (27 minutes) and Western Australia (28 minutes). The Australian Capital Territory recorded the longest median wait time of 50 minutes, more than double that of the national average.

median emergency wait time

2. 90th percentile waiting time

The “90th percentile waiting time” is the time within which 90% of patients received emergency clinical care in Australian public hospitals.

In 2018-19, the national 90th percentile emergency wait time in Australian public hospitals was
1 hour and 40 minutes.

According to the AIHW, the above national average was fairly consistent to those from the previous four years, varying from 1 hour and 33 minutes to 1 hour and 40 minutes.

The AIHW found both New South Wales and Queensland emergency departments recorded a shorter 90th percentile wait time than the national average, with wait times of 1 hour and 21 minutes and 1 hour and 31 minutes respectively.

Although the 90th percentile wait time in Western Australia (2 hours and 1 minute) and South Australia (2 hours and 17 minutes) were considerably longer than the national average, the ACT was again found to be the poorest performer, with a 90th percentile wait time of 2 hours and 46 minutes.

90th percentile emergency wait time

What can impact your waiting time in emergency?

On top of the difference in emergency care waiting times between hospitals in general, another major factor that can determine how long you will wait is how urgent your need for medical care is perceived to be, which is called your triage category.

A triage category is usually assigned by a registered nurse or medical practitioner soon after your arrival at an emergency department.

The AIHW refers to the following five triage categories in their emergency care report:

Category 1: Resuscitation – to be seen immediately (within seconds)

Category 2: Emergency – to be seen within 10 minutes

Category 3: Urgent – to be seen within 30 minutes

Category 4: Semi-urgent – to be seen within 60 minutes

Category 5: Non-urgent – to be seen within 120 minutes

The AIHW found 71% of all patients who presented to the emergency department in Australia in 2018-19 were seen on time according to the definition of their triage category.

This national average proportion declined by 1% since 2017-18, and by 4% since 2013-14.

When breaking down the proportion of patients seen on time by each individual triage category, the AIHW found that 100% of patients requiring resuscitation (immediate care) and 75% of those requiring emergency care (within 10 minutes) were seen on time in 2018-19. However, of those who needed urgent care (within 30 minutes), only 63% were seen on time, which is a 1% decrease from the previous year.

Proportion seen on time emergency

Proportion seen on time: state-by-state comparison

Comparing state by state, the AIHW found the proportion of all patients seen on time in New South Wales was higher than the national average, with a result of 78% in 2018-19. Victoria was not far behind with a proportion of 71%, and Queensland with 69%. However, the ACT’s results were again in stark contrast to the national average, with only a 46% of patients seen on time across all triage categories in 2018-19.

Do you have to pay for care in the emergency department?

emergency care
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If you visit a public emergency department in Australia, and you hold a Medicare card, you are unlikely to face any out-of-pocket expenses for your care. Medicare generally covers all of the costs of public hospital services, including emergency treatment by doctors, specialists and nurses, according to Human Services.

If you visit a private hospital emergency department, you will usually be charged with a flat fee for treatment, unless you have an eligible veteran’s healthcare card or you are a worker’s compensation patient. This fee is not usually claimable under Medicare or private health insurance, meaning you will need to pay for this expense out of your own pocket.

Depending on the treatment you require, you may also incur additional costs in a private hospital for pathology (e.g. blood tests) or radiology (e.g. X-rays) services while in emergency. If you hold a Medicare card you may be able to claim a portion of these additional expenses under Medicare.

Payment for your emergency treatment at a private hospital may be required on the day of consultation and the fees will vary depending on the length and time of the emergency care received and what hospital you visit. For more information on the fees charged by a private hospital emergency department, you can visit their website or contact them by phone.

Does private health insurance cover private emergency care?

Health funds will typically only provide a level of hospital cover when you’re formally admitted to a private hospital as an inpatient, meaning a doctor has assessed that you need ongoing hospital care and you have been assigned a bed. If you arrive to a private hospital emergency department and are not formally admitted to hospital you are considered an outpatient and as such any of the care you receive in emergency will not be covered by your private health insurance.

Getting to the emergency department – what to consider

ambulance emergency department
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The AIHW found that approximately 25% of the eight million patients that arrived at emergency in 2018-19 came by ambulance, air ambulance or helicopter rescue service.

However, in Australia the costs of ambulance services to a hospital emergency department is not covered by Medicare. This means that in some states and territories, except Queensland and Tasmania (where ambulance services are free for residents), you will be charged for using these services. There are, however, health insurance options available for ambulance cover, which could help you claim back some of the expenses of these services should you need to use them. Some health insurers may offer ambulance cover in the form of a standalone ambulance insurance policy, or they may include it under their hospital and extras products.

For more information, Canstar has provided a breakdown of ambulance insurance cover options and cost considerations in New South Wales, Victoria and for visitors to Queensland.

Cover image source: Nils Versemann (Shutterstock)

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