The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98-336 and 42-127 for younger and older groups, respectively. The excess costs in 2012-13 prices are estimated to range between AU$51,000-184,000 (0-64) and AU$27,000-84,000 (65+). By 2060, these estimates will increase to 229-2300 and 145-1188 at a cost of between AU$120,000-1,200,000 and AU$96,000-786,000 for the respective age groups. Improvements in climate change mitigation and adaptation measures are likely to generate synergistic health co-benefits and reduce the impact on frontline health services. Increasing demand for Australian public hospital emergency departments (ED) is associated with crowding and adverse health outcomes 1, 2 , and considerable costs. While many studies report factors such as population aging, extended models of care, patient's characteristics (socio-demographic, health and cognitive status), and seasonal illnesses and pandemics (e.g. influenza outbreaks) as general explanations for the increase 3 , recent studies confirm the effects of heatwaves and high temperatures on ED utilisation [4] [5] [6] . Additionally, monitoring emergency and acute health effects of high temperatures can assist with preparing response plans and implementing early warning programs to minimise the risk 7, 8 . There is an urgent need for a long-term and systematic approach to disaster preparedness, health care resilience and improving the surge capacity of the emergency health system 9, 10 . The Fifth Report by Intergovernmental Panel on Climate Change (IPCC) projects that the average global surface temperature will increase by up to 4 °C by 2100 relative to [1986][1987][1988][1989][1990][1991][1992][1993][1994][1995][1996][1997][1998][1999][2000][2001][2002][2003][2004][2005] 11 . Unless actions are taken to adapt, the adverse heat-related health consequences will also increase, resulting in even
For example, by using current trends and estimates in conjunction with future population growth and climate change scenarios, G. Toloo et al. REF studied the effects of increasingly warmer temperatures on the burden of already overcrowded hospital EDs.
Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios
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