Emergency Room Visits Are on the Rise

May 19, 2010 -- Americans have been going to emergency rooms (ERs) for treatment in increasing numbers since 1996, with poor and uninsured people more likely to seek treatment than others, the CDC says.

The increase in emergency room visits has come at a time when the number of ERs has decreased, causing overcrowding, longer wait times, and rising health care costs, according to the CDC's National Center for Health Statistics.

"As national health care costs continue to rise and policymakers become increasingly interested in ways to make the health care system more efficient, it is important to understand the characteristics of those individuals who use EDs (emergency departments) -- often in place of other sources of ambulatory care," the report states.

The CDC reports that:

• One in five people in the U.S. had one or more emergency room visits over a 12-month period in 2007.
• The uninsured between 45 and 64 were no more likely than those with private insurance to report at least one emergency room visit. The same was true for children.
• Among adults 18-44 the uninsured were more likely than those with private insurance to have at least one ER visit.
• Medicaid patients were more likely to have reported multiple ER visits than people with private insurance, as well as the uninsured.
• As family income increased, the likelihood of having visited an ER decreased. Income differences were more pronounced than those based on age, race, or ethnicity.
• Adults 75 and over were more likely to have reported at least one ER visit in a12-month period than younger people.
• Non-Hispanic black people were more likely to have reported one or more ER visits in a 12 month period than non-Hispanic whites or Hispanics.
• In 2007, 10% of ED visits by people under age 65 were considered nonurgent.

The numbers paint a clear picture, showing a strong correlation between income levels and a tendency to seek treatment in emergency departments, which is costly for hospitals, and causes costs to individuals to rise, as well as increases in health insurance premiums.

Also, the report states, adults in fair or poor health are much more likely to use emergency departments than people describing themselves as in very good or excellent health. Factors such as age, insurance status, perceived health status and race and ethnicity all play roles in ER visits.

"Future work should focus on untangling the complex interactions among the socio-demographic, health status and health care access factors that appear to be associated with visits to the ED (emergency department)," the CDC says.

Medicaid and ER Visits

The numbers also show an apparent tendency of Medicaid beneficiaries to go to emergency departments more often than others. The report says 15% of Medicaid beneficiaries under 65 had two or more ER visits, compared with 7% of the uninsured and 5% of people with private insurance.

The percentage of Medicaid beneficiaries under 65 with four or more ER visits over a 12-month period was highest at 5% compared to 2% among the uninsured and 1% of those with private insurance.

The report says that 10% of ER visits in 2007 by people under 65 were considered non-urgent.

People on Medicaid may seek emergency treatment more often than those with private insurance coverage or the uninsured because of higher rates of disability and chronic medical conditions, the CDC says.