Almost Half of Medical Care Delivered in Emergency Rooms

A new study reveals that nearly half of all medical care in the United States is delivered by emergency departments (EDs).

Researchers at George Washington University (GW, Washington, DC, USA), the University of Maryland School of Medicine (UMSOM; Baltimore, USA), and other institutions examined publicly available data from the US National Ambulatory Medical Care Survey and the National Hospital Discharge Survey databases in order to quantify the contribution of ED care to overall U.S. health care. The data covers all 50 states and the District of Columbia for the period of 1996 to 2010.

The results revealed nearly 130 million ED visits, compared with almost 101 million outpatient visits and nearly 39 million inpatient visits, signifying that an average of 47.7% of medical care in the United States is delivered in the ED. Analysis revealed that this percentage increased by 44% over the 14-year study period. The researchers found that certain groups were significantly more likely to use the ED as their method of healthcare, including African-American patients, who used the ED 54% of the time. The rate was even higher for urban African-Americans, who used emergency care 59% of the time in 2010.

Other categories of patients that tended to use the ED as their primary point of care were Medicare and Medicaid beneficiaries and those without any type of insurance; patients living in the Southern and Western states, who used the ED 54% and 56% of the time, respectively; in the Northeastern states ED use was much lower, at 39% of all visits. Women also tended to use the ED more often. The authors suggest the findings point to increasing ED use by vulnerable populations due to socioeconomic and racial inequality that creates barriers to the use health care. The study was published on October 17, 2017, in the International Journal for Health Services.

“I was stunned by the results. This really helps us better understand health care in this country. This research underscores the fact that emergency departments are critical to our nation's healthcare delivery system,” said lead author David Marcozzi, MD, co-director of the UMSOM Program in Health Disparities and Population Health. “Patients seek care in emergency departments for many reasons. The data might suggest that emergency care provides the type of care that individuals actually want or need, 24 hours a day.”

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George Washington University
University of Maryland School of Medicine