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Senior Citizens Lead Record Visits to America's
Emergency Departments
May 26, 2005 – Senior Citizens and Medicaid
patients are leading the charge to the nation’s hospital emergency
departments where visitors reached a record high of nearly 114 million
in 2004, according to a report released this week by the Centers for
Disease Control and Prevention (CDC). Those in nursing homes or without
insurance are most likely to choose EDs.
The report attributes the rise in ED visits to
increased use by adults, especially those 65 years old and over. Among
people aged 65-74, the ED visit rate was more than five times higher for
those residing in a nursing home or other institution compared with
those not living in an institutionalized setting.
The report also finds that Medicaid patients were
four times (81 visits per 100 people) more likely to seek treatment in
from an ED than those with private insurance (22 visits per 100 people.)
“Emergency departments are a safety net and often
the place of first resort for health care for America’s poor and
uninsured,” said Linda McCaig of CDC’s National Center for Health
Statistics and the report’s lead author. “This annual study of the
nation’s emergency departments is part of a series of surveys of health
care in the United States and provides current information for the
development of policies and programs designed to meet America’s health
care needs.”
Making the situation worse, the report found the
number of EDs decreased by 14 percent from 1993 to 2003.
Other findings in the report include:
-
From 1993 through 2003, the number of ED visits
increased 26 percent from 90.3 million visits in 1993 to 114 million
in 2003. The U.S. population rose 12.3 percent during this period,
and the 65-and-over population rose 9.6 percent.
-
The average waiting time to see a physician was
46.5 minutes, the same as it was in 2000. The wait time was
unchanged despite increased visits. EDs have implemented a number of
efficiencies, including “fast track” units, which may have kept the
wait time constant. On average, patients spent 3.2 hours in the ED,
which includes time with the physician as well as other clinical
services.
-
Injury, poisoning and the adverse effects of
medical treatment accounted for over 35 percent of ED visits. The
leading causes of injuries were falls, being struck by or striking
against objects or persons, and motor vehicle traffic incidents,
accounting for 41 percent of injury-related visits. Some 1.7 million
visits were for adverse effects of medical treatment.
-
In 2003, patients arrived at the ED by
ambulance in 14 percent of the visits, representing over 16 million
ambulance transports. More than a third of patients who arrived at
the ED by ambulance were 65 years of age and over.
-
X-rays, CT scans or other imaging tests were
provided in about 43 percent of visits. Medications were provided in
over 77 percent of visits, with painkillers being the most frequent
prescription, accounting for just over 14 percent of medications
reported.
-
About 58 percent of all EDs were located in
metropolitan areas, and they represented 82 percent of the annual
usage. Board-certified emergency medicine physicians were available
at 64 percent of EDs and almost half of all EDs had a nursing triage
system.
The CDC report describes hospital, patient and
visit characteristics for hospital emergency departments in the United
States as well as trends in ED use between 1993 and 2003. The
information is based on data from the 2003 National Hospital Ambulatory
Medical Care Survey (NHAMCS) Emergency Department Summary, which is a
national probability-based sample survey of visits to emergency and
outpatient departments of non Federal, short stay, and general hospitals
in the United States conducted by CDC’s National Center for Health
Statistics.
For a copy of the full report visit
www.cdc.gov/nchs.
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