Emergency department overcrowding and mortality after the introduction of the 4-hour rule in Western Australia

Dylan J Toh, Campbell H Thompson, Josephine S Thomas and Jeffrey Faunt
Med J Aust 2012; 196 (8): . || doi: 10.5694/mja12.10304
Published online: 7 May 2012

To the Editor: We read with interest the article by Geelhoed and de Klerk1 regarding the mortality benefits of a policy that ensures high numbers of patients are admitted to hospital within 4 hours of arrival at an emergency department (ED). The proof of improved performance following service intervention within a complex institution requires careful consideration. We offer an alternative interpretation of their data.

  • Dylan J Toh1
  • Campbell H Thompson2
  • Josephine S Thomas2
  • Jeffrey Faunt1

  • 1 Royal Adelaide Hospital, Adelaide, SA.
  • 2 University of Adelaide, Adelaide, SA.


Competing interests:

No relevant disclosures.


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