Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

How does ambulance service utilisation impact demand for Emergency Departments in Queensland, Australia?

Background: There are indications that pre-hospital emergency care and management of patients can help reduce the demand for hospital emergency departments (EDs). Ambulance services play a significant role at this stage of care. In 2003, the Queensland Government introduced a Community Ambulance Cover (CAC) levy in return for a free ambulance service at the point of access to all Queenslanders. This may have led to the impression in consumers of an entitlement to free ambulance services under any circumstances regardless of the urgency of the matter which may have in turn contributed to the crowding of EDs in Queensland. Objectives: This paper aims to answer the following questions: - How many patients arrive at hospital EDs by ambulance in Queensland, compared to other modes of arrival? - How has this changed over time, particularly after the CAC introduction in 2003? What percentage of ambulance arrivals are urgent ED patients? - Has the perceived free ambulance services created extra demand for EDs in Queensland, compared with other Australian jurisdictions that charge patients for ambulance services? Methods: We will secondary analyse the data from sources such as Queensland Ambulance Services, Department of Health and Australian Bureau of Statistics to answer the research questions. Findings and Conclusions Queensland has the highest utilization rate of ambulance services (about 18% in 2007-08) and the highest annual growth rate in demand for these services (7.7% on average since 2000-01), well above the population growth. On the other hand, the proportion of ED patients arriving by ambulance in Queensland has increased by about 4% annually. However, when compared with other states and territories with charge at the point of access, it seems that the growth in demand for EDs cannot be explained solely or mainly by CAC or ambulance utilisation in Queensland.

Estimating short and long-term residential demand for electricity : new evidence from Sri Lanka

This study investigates the short-run dynamics and long-run equilibrium relationship between residential electricity demand and factors influencing demand - per capita income, price of electricity, price of kerosene oil and price of liquefied petroleum gas - using annual data for Sri Lanka for the period, 1960-2007. The study uses unit root, cointegration and error-correction models. The long-run demand elasticities of income, own price and price of kerosene oil (substitute) were estimated to be 0.78, - 0.62, and 0.14 respectively. The short-run elasticities for the same variables were estimated to be 032, - 0.16 and 0.10 respectively. Liquefied petroleum (LP) gas is a substitute for electricity only in the short-run with an elasticity 0.09. The main findings of the paper support the following (1) increasing the price of electricity is not the most effective tool to reduce electricity consumption (2) existing subsidies on electricity consumption can be removed without reducing government revenue (3) the long-run income elasticity of demand shows that any future increase in household incomes is likely to significantly increase the demand for electricity and(4) any power generation plans which consider only current per capita consumption and population growth should be revised taking into account the potential future income increases in order to avoid power shortages ill the country.

Identifying aggregate demand and supply shocks in a small open economy

The standard Blanchard-Quah (BQ) decomposition forces aggregate demand and supply shocks to be orthogonal. However, this assumption is problematic for a nation with an inflation target. The very notion of inflation targeting means that monetary policy reacts to changes in aggregate supply. This paper employs a modification of the BQ procedure that allows for correlated shifts in aggregate supply and demand. It is found that shocks to Australian aggregate demand and supply are highly correlated. The estimated shifts in the aggregate demand and supply curves are then used to measure the effects of inflation targeting on the Australian inflation rate and level of GDP.

Standardization and omics science : technical and social dimensions are inseparable and demand symmetrical study

Standardization is critical to scientists and regulators to ensure the quality and interoperability of research processes, as well as the safety and efficacy of the attendant research products. This is perhaps most evident in the case of “omics science,” which is enabled by a host of diverse high-throughput technologies such as genomics, proteomics, and metabolomics. But standards are of interest to (and shaped by) others far beyond the immediate realm of individual scientists, laboratories, scientific consortia, or governments that develop, apply, and regulate them. Indeed, scientific standards have consequences for the social, ethical, and legal environment in which innovative technologies are regulated, and thereby command the attention of policy makers and citizens. This article argues that standardization of omics science is both technical and social. A critical synthesis of the social science literature indicates that: (1) standardization requires a degree of flexibility to be practical at the level of scientific practice in disparate sites; (2) the manner in which standards are created, and by whom, will impact their perceived legitimacy and therefore their potential to be used; and (3) the process of standardization itself is important to establishing the legitimacy of an area of scientific research.

Effect of rain on travel demand and traffic accidents

This paper studies the effect of rain on travel demand measured on the Tokyo Metropolitan Expressway (MEX). Rainfall data monitored by the Japan Meteorological Agency's meso-scale network of weather stations are used. This study found that travel demand decreases during rainy days and, in particular, larger reductions occur over the weekend. The effect of rainfall on the number of accidents recorded on 10 routes on the MEX is also analysed. Statistical testing shows that the average frequency of accidents, during periods of rainfall, is significantly different from the average frequency at other times.

Sensitivity of the lane change test as a measure of in-vehicle system demand

The Lane Change Test (LCT) is one of the growing number of methods developed to quantify driving performance degradation brought about by the use of in-vehicle devices. Beyond its validity and reliability, for such a test to be of practical use, it must also be sensitive to the varied demands of individual tasks. The current study evaluated the ability of several recent LCT lateral control and event detection parameters to discriminate between visual-manual and cognitive surrogate In-Vehicle Information System tasks with different levels of demand. Twenty-seven participants (mean age 24.4 years) completed a PC version of the LCT while performing visual search and math problem solving tasks. A number of the lateral control metrics were found to be sensitive to task differences, but the event detection metrics were less able to discriminate between tasks. The mean deviation and lane excursion measures were able to distinguish between the visual and cognitive tasks, but were less sensitive to the different levels of task demand. The other LCT metrics examined were less sensitive to task differences. A major factor influencing the sensitivity of at least some of the LCT metrics could be the type of lane change instructions given to participants. The provision of clear and explicit lane change instructions and further refinement of its metrics will be essential for increasing the utility of the LCT as an evaluation tool.

Reconciling the supply of and demand for carbon cycle science in the US agricultural sector

When asking the question, ``How can institutions design science policies for the benefit of decision makers?'' Sarewitz and Pielke Sarewitz, D., Pielke Jr., R.A., this issue. The neglected heart of science policy: reconciling supply of and demand for science. Environ. Sci. Policy 10] posit the idea of ``reconciling supply and demand of science'' as a conceptual tool for assessment of science programs. We apply the concept to the U.S. Department of Agriculture's (USDA) carbon cycle science program. By evaluating the information needs of decision makers, or the ``demand'', along with the supply of information by the USDA, we can ascertain where matches between supply and demand exist, and where science policies might miss opportunities. We report the results of contextual mapping and of interviews with scientists at the USDA to evaluate the production and use of current agricultural global change research, which has the stated goal of providing ``optimal benefit'' to decision makers on all levels. We conclude that the USDA possesses formal and informal mechanisms by which scientists evaluate the needs of users, ranging from individual producers to Congress and the President. National-level demands for carbon cycle science evolve as national and international policies are explored. Current carbon cycle science is largely derived from those discussions and thus anticipates the information needs of producers. However, without firm agricultural carbon policies, such information is currently unimportant to producers. (C) 2006 Elsevier Ltd. All rights reserved.

Peak power demand reduction under moving block signalling using an expert system

The concept of moving block signallings (MBS) has been adopted in a few mass transit railway systems. When a dense queue of trains begins to move from a complete stop, the trains can re-start in very close succession under MBS. The feeding substations nearby are likely to be overloaded and the service will inevitably be disturbed unless substations of higher power rating are used. By introducing starting time delays among the trains or limiting the trains’ acceleration rate to a certain extent, the peak energy demand can be contained. However, delay is introduced and quality of service is degraded. An expert system approach is presented to provide a supervisory tool for the operators. As the knowledge base is vital for the quality of decisions to be made, the study focuses on its formulation with a balance between delay and peak power demand.

Estimating the latent demand for rail transit : a case study in Perth, Western Australia

This paper presents a study on estimating the latent demand for rail transit in Australian context. Based on travel mode-choice modelling, a two-stage analysis approach is proposed, namely market population identification and mode share estimation. A case study is conducted on Midland-Fremantle rail transit corridor in Perth, Western Australia. The required data mainly include journey-to-work trip data from Australian Bureau of Statistics Census 2006 and work-purpose mode-choice model in Perth Strategic Transport Evaluation Model. The market profile is analysed, such as catchment areas, market population, mode shares, mode specific trip distributions and average trip distances. A numerical simulation is performed to test the sensitivity of the transit ridership to the change of fuel price. A corridor-level transit demand function of fuel price is thus obtained and its characteristics of elasticity are discussed. This study explores a viable approach to developing a decision-support tool for the assessment of short-term impacts of policy and operational adjustments on corridor-level demand for rail transit.