More Americans Seek Medical Care in Hospital Emergency Rooms

Injuries Cause One in Three Visits

For Release: Wednesday, June 4, 2003

Contact: NCHS Press Office (301) 458-4800

National Hospital Ambulatory Medical Care Survey: 2001 Emergency Department Summary. Advance Data No. 335. 36 pp. (PHS) 2003-1250. [PDF – 1.7 MB]

Visits to America’s emergency departments are up 20 percent over the past decade, says the latest annual report from CDC’s National Hospital Ambulatory Medical Care Survey. Continuing a growing trend, there were an estimated 107.5 million visits to hospital emergency departments in 2001, compared to 90 million in 1992. This increase is due, in part, to overall population growth in the United States, as well as an increase in older adults who tend to visit hospital emergency departments more often than younger people. During the same period, the number of emergency departments in the United States decreased by about 15 percent.

This year’s report includes new information about emergency departments. Hospitals in metropolitan areas and those affiliated with medical schools tend to have a larger volume of emergency department visits. Larger emergency departments are more likely to have an automated drug dispensing system to reduce medication errors. About half of hospitals with 24-hour emergency departments also have outpatient department clinics offering physician services.

Injury, poisoning and adverse effects of medical care account for more than a third of all visits, with falls the leading injury. About 6 percent of injuries are intentional—either self-inflicted or the result of an assault. Patients experiencing an adverse effect of medical treatment, such as an allergic drug reaction or complication of surgery, accounted for 1.4 million visits.

Abdominal pain, chest pain, and fever are the most commonly recorded principal reasons (patient symptoms) for the visit. The most frequent primary diagnoses are contusions, acute upper respiratory infections, and open wounds. In approximately 30 percent of all visits, patients came to the emergency department with an elevated blood pressure (greater than 140 mmHg/90 mmHg).

About three-quarters of emergency department patients receive medications during the visit; on average, about 2 drugs each. Pain relief medications were the most frequently prescribed in 2001 – accounting for just over a third of medicines used during emergency department visits. Antibiotics are the second most frequent, followed by medications designed to treat respiratory tract ailments.

Older Americans have the highest rate of visits to the emergency department with about 60 visits for every 100 persons 75 years of age or older (compared to 38 visits per 100 for people of all ages). For the first time, the survey can identify visits made by nursing home residents. In 2001, about 3 percent of emergency department visits were made by patients residing in a nursing home or other institution. One third of these visits were for injuries.

Three million emergency department visits involved patients who had been seen previously in the ED within the last 72 hours, and almost 6 percent of all visits were for follow-up of the same problem. No follow-up was planned for about 10 percent of visits. For 40 percent of visits, the patient was referred to another physician or clinic and, for approximately 12 percent of the visits, patients were admitted to the hospital.

Other key findings from the survey show that:

Patients spent, on average, three hours in the emergency department, but length of visit varied by hospital size and geographic region.
Imaging was provided at approximately 40 percent of all visits; use of MRI/CAT scan has increased by over 160 percent from 1992 to 2001.
Private insurance was listed as the dominant expected source of payment, accounting for 40 percent of ED visits, followed by Medicaid at 18 percent, and Medicare at 15 percent.
Only 10 percent of patient visits were classified as non-urgent.
Arrival times for elderly patients in the emergency department peak at 11a.m, while those for children peak between 7 to 8 p.m.

CDC’s National Center for Health Statistics conducts this annual survey of visits to the emergency department as part of its National Health Care Survey, which also covers doctors’ offices, hospitals, nursing homes, hospices, and home health care. The survey examines health care across a range of settings and monitors patterns and shifts in the way health care services are provided and used.

“National Hospital Ambulatory Medical Care Survey: 2001 Emergency Department Summary” can be viewed at CDC/NCHS web site. The Web site also contains additional information about the survey based on records from a representative sample of the nation’s emergency departments.

CDC protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.