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1994.03.02 : NCHS's Study on Visits to Emergency Rooms

FOR IMMEDIATE RELEASE          Sandra Smith (301) 436-7551
Wednesday, March 2, 1994       Jeffrey Lancashire (301) 436-7135


     The majority of visits to hospital emergency departments are
not for emergencies, according to the first national survey of
hospital emergency departments released today by HHS Secretary 
Donna E. Shalala.

     Americans made almost 90 million visits to hospital emergency
departments in 1992 and 55 percent of those visits were non-urgent.
Almost as many people came to the emergency room for coughs and
sore throat as came to the emergency room for chest pain, the study
found. 

     "This study shows how emergency rooms have become the 'family
doctor' for too many Americans," Secretary Shalala said.  "But
emergency rooms are not intended to deliver routine medical care. 
Patients at emergency rooms don't get the timely, preventive
services that come with regular medical care.  And the cost is 
three times higher than visits to the doctor's office."

     The survey showed that persons aged 75 and older had the
highest rate of emergency room visits.  However, it also showed
that younger persons (those aged 0-24 years) had the highest rates
of non-urgent visits.

     For those aged 0-24, some 61 percent of emergency room visits
were non-urgent; while only 34 percent were non-urgent for those 75
and older.  

     "Our health care system is not working at its best when so
many emergency room visits are for non-urgent purposes," Secretary
Shalala said.  "To achieve a health care system that works better
and costs less, one key element is regular, on-going care in a
clinic or a physician's office.

     "That kind of regular care comes with health insurance
coverage," she said.  "And that's one reason why universal coverage
is an absolutely necessary part of health care reform."

     The survey by the National Center for Health Statistics
classified non-urgent visits as those which did not require
attention immediately or within a few hours. 

     The survey found that: 

     --  For every 100 persons 75 years of age and over, there were
an estimated 56 visits to the emergency room.  The next highest
visit rate was for those 15-24 years (43.2 per 100 persons).     

     --  Those with the highest rate of non-urgent visits to
emergency rooms were persons aged 15-24 (26.3 per 100 persons),
0-14 (24.2); and 25-44 (19.9).

     -- Fifty-nine percent of visits were made for illness and 35
percent for injury.  Visits for injury were no more likely to be
considered urgent than were visits for illness.  Just over half (55
percent) of visits for illness and visits for injury were non-
urgent.

     --  The most frequent diagnosis recorded was otitis media (ear
infection), accounting for over 3.1 million visits.  

     --  The survey also examined the patient's reason for visit. 
Chest pain was reported as the reason for visit in 4.6 million
visits.  Cough and sore throat were the reason for 2 million visits
each.         

     --  Almost 31.6 million visits to the hospital emergency
department were made for injury.  The most frequent injury recorded
was head wound, with 2.6 million visits.  Teen-agers and young
adults had the highest rate of injury-related visits; males had
higher rates than females.

     --  Accidental falls (7.7 million) were the most frequently
specified cause of injury resulting in a visit to the emergency
room.  Motor vehicle-related injuries (4.1 million) were next,
followed by intentional injuries, including homicide (1.6 million).

     -- The government was the most frequent source of payment for
emergency care, covering a total of 42 percent of all visits.
Medicaid was the expected source of payment for 23 percent of
visits and Medicare, 15 percent.  Private/commercial insurance
accounted for 36 percent. 

     --  The visit rate for black Americans was almost double the
rate for the white population overall.  Differences were noted for
all age groups, except for those 75 and over.  

     "National Hospital Ambulatory Medical Care Survey:  1992
Emergency Department Summary," by Linda F. McCaig presents the
findings from the 1992 National Hospital Ambulatory Medical Care
Survey, covering the care provided in emergency departments of non-
federal, short-stay hospitals.    

     A copy of the report is available from NCHS, 6525 Belcrest
Road, Hyattsville, Md. 20782.  

     NCHS is part of the Centers for Disease Control and
Prevention, one of the eight agencies of the U.S. Public Health
Service, HHS.