Characteristics and outcomes of patient presentations made by police to an Australian emergency department

Abstract

Objective: To describe and compare characteristics and outcomes of patient presentations brought in by police (BIBP) with those not BIBP (NBIBP) to one Australian ED. Methods: A retrospective observational study. All patient presentations to a tertiary hospital ED made during the period 8 October 2012 to 7 April 2013 were included. Routinely collected ED information data and medical record review data were used. ED care delivery for people BIBP from the watch house (WH) or other location was compared. Univariate comparison and multivariate logistic regression analyses were performed to identify the different characteristics and ED outcomes between BIBP and NBIBP groups. Results: A total of 35 127 ED presentations occurred within the 6 month period; 392 (1.1%) were BIBP. Compared with those NBIBP, those BIBP were diagnosed with ‘psychiatric’ and ‘toxicology-related’ illnesses in higher proportions. Overlap in health conditions (primarily for physical health reasons) between those BIBP and NBIBP existed. Presentations BIBP from the WH reflected ‘physical health emergencies’ whereas presentations BIBP from other locations reflected ‘behavioural emergencies’. Compared to those NBIBP, those BIBP had a longer wait to be seen (by about 5 min), longer ED length of stay (LOS) if not admitted (by about 20 min) but shorter ED LOS if admitted (by about 59 min). When adjusted for sex, age group and diagnosis, ED LOS (if admitted) and admission rate were statistically significant. For those BIBP, mental health related orders and alcohol breath tests were common. Conclusions: Patients BIBP were different to those NBIBP. Despite comprising a small proportion of overall ED attendances, they are a group where mental health and drug and alcohol issues are over-represented. Differences in ED care delivery for those BIBP highlights potential opportunities for pre-hospital healthcare interventions.