Time again experts urge people not to come to the emergency department (ED) for non-urgent healthcare, but a new study has found patients are not to blame for ED overcrowding.
The study published in the New Zealand Medical Journal on Friday found around 95 percent of New Zealanders visit EDs when that is the appropriate care.
"ED crowding is not caused by the people that don't come appropriately. ED crowding is caused by our inability to get people through the system in a timely way," University of Auckland Associate Professor in Medical Surgery and author of the study Peter Jones told AM.
The study found ED crowding was primarily caused by insufficient resources within hospitals to cope with the appropriate demand for emergency care, especially timely access to hospital wards for admitted patients known as "access block".
"That's the cause of ED crowding, that's the cause of ambulance ramping and that's what leads to the problems that we've seen reported very well by the media in the last couple of years," Jones said.
The numbers of people going to ED are also slowly creeping up in time, Jones said.
The study found that age-adjusted ED presentations per 100,000 population have risen approximately 0.7 percent per year from 2008–2022. However, that figure is low by international standards.
New Zealand needs to shift towards staffing and resourcing hospitals appropriately to deal with the workload that comes, Jones said.
"We have been unravelling with our care in hospitals for probably six years or so with respect to what's reflected in ED crowding but COVID exacerbated that," he added.
New Zealand relies heavily on overseas health staff so when we turned off the immigration tap for a couple of years Jones said it's no surprise we have a staffing shortfall. But the health workforce issue is worldwide which has compounded our problems.
He said one of the key factors is our general medicine specialty is vastly underrated. Jones said general medicine does most of the hard yards when it comes to acute care and it's not a very popular specialty and is under-resourced.
"We need to support them so we can look after our hospital patients better."
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