Overview
Each year, ACEM distributes the Annual Site Census to Directors of Emergency Medicine and Directors of Emergency Medicine Training at all ACEM-accredited emergency departments (ED) across Australia and Aotearoa New Zealand. Findings from the census are used to monitor activity, staffing and resources of accredited sites and provide an evidence base for ACEM policy and advocacy initiatives relating to ED workforce and functioning.
The 2024 site census was distributed to 148 ACEM-accredited sites. ED activity and case mix data were sought from 1 July 2023 to 30 June 2024, with all other data being current at the time of completing the survey.
All 148 sites (128 in Australia and 20 in Aotearoa) that were ACEM-accredited at the time of data collection submitted the 2024 census. Data is reported by region (country/state or territory), remoteness/delineation and by the range of annual presentations. ED remoteness & delineation separates EDs by Modified Monash Model (MMM) in Australia and by Geographical Classification for Health (GCH) in Aotearoa. In Australia, EDs in metropolitan (MMM 1) areas are separated into sub-categories which include major referral, non-major referral, specialist (children’s and women’s hospitals), and private. While EDs located in MMM2 are classified as regional and EDs in MMM 3-7 are combined (due to the low number of EDs) and classified as rural and remote. In Aotearoa, all ACEM-accredited EDs are located within Urban 1 or Urban 2 areas. There is only one specialist children’s hospital in Aotearoa that is ACEM-accredited, the data for this ED has been incorporated into the Urban 1 category.
Key data is shown in the visuals on this page with more comprehensive data available in the supplementary file that can be downloaded at the bottom of the page.
ED activity and case mix
From 1 July 2023 to 30 June 2024, a total of 8,591,812 attendances were reported at ACEM-accredited EDs. The average number of annual ED attendances was 58,278 at Australian EDs (2.2% increase vs. 2023 census) and 56,608 at Aotearoa New Zealand EDs (1.6% increase vs. 2023 census).
The figure also shows the proportion of attendances aged 0–14 years and 65+ years, the proportion of patients that arrived by ambulance and the proportion classified in the most urgent triage categories (ATS 1-3).
24-hour ED length of stay
Between 1 July 2023 and 30 June 2024, 114,379 attendances to ACEM-accredited EDs, or 1.3% of total attendences, were reported to have a length of stay over 24 hours. By region, Tasmanian EDs had the highest proportion of total ED attendances with a length of stay greater than 24 hours (4.3%). By remoteness, regional EDs had the highest proportion of ED attendances with a length of stay greater than 24 hours (2.4%).
Across ACEM-accredited EDs, the proportion of discharged patients who had a length of stay greater than 24 hours (0.3%) was significantly lower than the proportion of inpatient admissions (4.6%), inter-hospital transfers (6.6%) and ED SSU admissions (4.6%) (data available in supplementary data).
EM specialist and FACEM trainee staffing profiles
In 2024, the average full-time equivalent (FTE) of EM specialists across ACEM-accredited EDs was 16.8. The average FTE of FACEM trainees in training stage 1 was 3.2, compared with 7.5 FTE for those in training stages 2 – 4.
The EM specialist FTE to headcount ratio was 1 : 1.6, meaning an average of 1.6 emergency medicine specialists were required to fill every 1 FTE position. On average, accredited EDs had 0.6 FTE of FACEM trainees for every 1 FTE of EM specialists. The figure also shows the ratio of emergency medicine specialists and FACEM trainees to ED attendances.
EM specialist and FACEM trainee vacancies
The proportion of accredited EDs with funded but unfilled FTE (i.e. vacancies) for EM specialists was smaller in 2024 (45.3%) than in 2023 (54.1%). There were an overall 155.6 unfilled FTE of EM specialists reported across Australia and Aotearoa New Zealand. The proportion of accredited EDs reporting FACEM trainee vacancies also decreased in 2024 (52.0%) compared to the 2023 Census (65.5%).
EDs located in regional, rural and remote areas of Australia and Urban 2 areas in Aotearoa New Zealand were more likely to report having funded but unfilled FTE for EM specialists, than EDs in metropolitan areas. EDs with 50,000 – 65,000 annual presentations were most likely to report having EM specialist vacancies (55.6%), and EDs with 40,000 – 50,000 annual presentations were most likely to report having FACEM trainee vacancies (73.1%).
ED treatment spaces and resources
The average number of treatment spaces (beds and chairs) across ACEM-accredited EDs was 50.2, with one treatment space per 1,164 ED attendances. Approximately half of the spaces were designated as acute beds (average of 23.6 per ED).
Trends in average EM workforce FTE, annual presentations, and treatment spaces over time
Recent years of Annual Site Census data has been collated to track the trend in key metrics between 2021 and 2024. The figure shows the trends in EM workforce FTE, annual presentations and treatment spaces. The ratio of EM workforce FTE and ED treatment space to the number of ED presentations are also shown in the figure.
Additional data is available in the supplementary data tables below. For further enquiries about ACEMs Annual Site Census please contact [email protected].