Evaluating the impact of an Australian Virtual Care service on low-acuity presentations to district emergency departments: an interrupted time series analysis

Objective To evaluate the impact of an Australian Virtual Care service on low-acuity patient presentations to emergency departments (EDs) across a local health district. Design This was a retrospective study using an interrupted time series analysis to compare outcomes before and after the introduction of Mid North Coast Virtual Care (MNCVC). The comparison of these periods aims to identify changes in the rate of semi-urgent (category 4) and non-urgent (category 5) ED presentations following the intervention. Setting This analysis covers the Mid North Coast Local Health District, a coastal region in New South Wales, Australia. It encompasses EDs in Port Macquarie, Coffs Harbour, Kempsey, Macksville, Dorrigo and Bellingen. Main outcome measure Whether there was a reduction in low-acuity ED presentations (category 4 and 5) as a proportion of total ED presentations at Mid North Coast EDs following the commencement of MNCVC as an alternative to ED attendance. Results In the years prior to intervention, the proportion of total ED presentations that were low-acuity presentations averaged 54.58%. Following intervention from July 2022 onwards, there was an immediate non-significant 1.04% decrease in the proportion of category 4 and 5 presentations (95% CI −2.11 to 0.04, p=0.063), with a further significant 0.12% decrease each month thereafter (95% CI −0.17 to −0.06, p<0.001). By December 2024, the model estimated a cumulative 4.64% decrease in the proportion of low-acuity presentations since the introduction of the virtual care service. Conclusions Following commencement of a virtual care service, a significant and sustained reduction in the proportion of low-acuity presentations was observed across the district EDs. Virtual care services may contribute to easing the burden of low-acuity presentations on EDs.