CDC Data Profiles America`s Recent ED Caseload

Lots of what you think you know about emergency care in America is probably correct. Some of it may not be. But if you want a huge and varied assortment of facts to sift through, the CDC provided it with its National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary, published in the August 6 National Health Statistics Reports.

The survey examines data from U.S. emergency department visits in 2007, looking at hospital, patient and visit characteristics relevant to problems identified by groups like the IOM and ACEP. These problems include ED overcrowding, lack of specialists, and gaps in pediatric care. There were around 117 million total ED visits that year; researchers used a national probability sample weighted to produce national estimates.

Some facts of interest to EMS providers:

• From 1997 to 2007, the annual number of visits to EDs increased by 23%.
• In 2007, there were 39.4 ED visits for every 100 Americans, or about 222 a minute.
• The age group with highest visit rate was infants under 12 months, with 88.5 per 100 infants.
• Those 75 and older had an annual visit rate of 62.0 per 100 persons.
• The visit rate for the homeless was almost twice that of those living in private residences (71.8 vs. 35.9 per 100).
• The visit rate for black Americans was more than double that of whites (74.6 vs. 35.9). Asians accounted for only 16.0 visits per 100 people.
• On 64.7% of ED visits, patients arrived during nonbusiness hours (5 p.m. to 8 a.m.).
• Patients arrived by ambulance on just 15.5% of ED visits, but that rate for those 75 and older was 44.9%.
• Uninsured patients accounted for 15.3% of visits.
• Expected payment sources included private insurance (39.0%), Medicaid or SCHIP (25.2%), and Medicare (17.2%).
• Patients were triaged as needing to be seen immediately on just 4.5% of ED visits, and within 1-14 minutes (emergent) on 11.3%.
• Top reasons for visits included fever, cough and vomiting for children under 15; chest and abdominal pain for those 15-64; and chest pain, shortness of breath and abdominal pain for those 65+.
• Most common primary diagnoses were acute upper respiratory infections and otitis media or Eustachian tube disorders for those under 15; abdominal pain and obstetrical complications for women 15-64; open wounds and contusions for men 15-64; and chest pain and nonischemic heart disease for those 65+.
• Of injury-related visits, 66.1% were for unintentional injuries, 5.1% for intentional injuries, 4.3% due to adverse effects from medical treatment, and 4.5% related to alcohol or drug abuse.
• The leading drugs given in the ED were acetaminophen (alone or with hydrocodone or oxycodone, 5.9% of drug mentions), ketorolac (3.3%), morphine (3.1%), and ibuprofen (3.0%).
• Patients died in EDs on just 0.1% of visits.