The identification of costs associated with emergency department attendances

Aims To calculate the cost of patient attendances to an emergency department and to identify the cost drivers of those attendances. Setting The Emergency Department, Flinders Medical Centre, a metropolitan teaching hospital in Adelaide, South Australia. Methods A prospective analysis of all attendances presenting over a five month period, incorporating detailed costings of staff and resource usage. The effects of four cost drivers were evaluated: urgency, outcome, age and diagnosis. Results The mean measured cost for each patient attendance was $103.79, varying from $36 for discharged category 5 patients to $429 for admitted category 1 patients. The mean total cost was $191.29, which included non‐measured and overhead components of $87.50. Conclusion This study identifies the costs associated with treating emergency department patients. We believe this study will be reproducible in other emergency departments. The variables that we predicted would influence the cost of clinical activities (urgency, outcome, age and diagnosis) were all found to be important determinants of the cost of emergency department attendances.