Background Emergency departments are seeing an ever-increasing number of patients each year due to various gaps in health services. The aim is to measure significant trends in patient numbers and ac.....

Background Recent work has shown a decrease in the burden of road trauma requiring hospitalization to three-quarters of pre-pandemic levels, but an increasingly disproportionate number of fatalities, in Victoria, Australia. This study aims to test that hypothesis with 25 years of data. Subject and methods Time series analysis was conducted for Transport Accident Commission (TAC) claims involving hospitalization and Australian Road Deaths Database fatalities in Victoria, Australia, from January 2000 to July 2024, including lockdown (March 2020 to October 2020) and post-lockdown (November 2020 onwards). Results A total of 149,113 claims and 7300 deaths were included. Total claims decreased significantly, by 21% (95% CI [1, 41], p < 0.05), from 518/month to 409/month. This reduction was consistent across the day of the week, time of day, hospital length of stay, and metropolitan versus rural location. A significant reduction in road injury was observed for females, i.e. −33% (95% CI [−52, −14], p < 0.01), but not for males, i.e. −19% (95% CI [−39, 1], p = 0.06). Despite this reduction in claims, total deaths have not decreased significantly—from 26/month to 24/month, −7% (95% CI [−28, 14], p = 0.525). Most notably, a consistently disproportionate increase in road fatalities was found, with the fatality-to-claim ratio (deaths per 1000 claims) increasing by 31% (95% CI [1–61], p < 0.05). Conclusion Four years after governmental lockdown, there is still a persistent reduction in road injury burden, but a disproportionate increase in road fatalities, in Victoria, Australia. Public health intervention should target this increased rate of road fatalities.