OBJECTIVE: To identify demographic disparities in US emergency department (ED) utilization. METHODS: Data were obtained from the 1992-1998 National Hospital Ambulatory Medical Care Survey (NHAMCS). National estimates were obtained using assigned patient visit weights. 95% CI were calculated using the relative standard error of the estimate. Rates were calculated using population data from the US Census Bureau, with all rates reported per 1,000 per year for US population. Regression was used for trend analysis. RESULTS: From 1992-1998, there were an estimated total of 655,675,577 ED visits, for a rate of 357 per year per 1,000 people. This rate remained stable between 1992-1998 (p for trend=0.34). The ED visit rate was highest for ages >75 (523, 95% CI 505-541) and <10 (452, 436-467). Rates were similar among males (348, 336-360) and females (365, 353-377), but much higher among blacks (588, 568-608) than whites (331, 320-342). The rate for blacks has risen steadily from 1992-1998 (1992=551, 1998=623, p for trend=0.001). 46% of visits were coded as urgent/emergent (black 42%, white 47%), while 12% of visits resulted in hospitalization (black 9%, white 13%). Insurance status was listed as self-pay for 16% of visits, with blacks (19%) higher than whites (15%), and as Medicaid for 23%, with blacks (36%) again higher than whites (20%). CONCLUSION: Half of ED visits are coded as urgent/emergent, and only 12% result in hospitalization. The black ED visit rate is high and steadily rising, with 19% lacking insurance and 36% using Medicaid. These disparities merit further investigation.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Discuss overall trends in emergency department utilization. 2. Describe age, gender and racial differences in emergency department utilization.
Keywords: Emergency Department/Room, Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.