New study: Nearly half of US medical care comes from emergency rooms

October 17, 2017, University of Maryland School of Medicine
Credit: CC0 Public Domain

Nearly half of all US medical care is delivered by emergency departments, according to a new study by researchers at the University of Maryland School of Medicine (UMSOM). And in recent years, the percentage of care delivered by emergency departments has grown. The paper highlights the major role played by emergency care in health care in the U.S.

"I was stunned by the results. This really helps us better understand in this country. This research underscores the fact that departments are critical to our nation's healthcare delivery system." said David Marcozzi, an associate professor in the UMSOM Department of Emergency Medicine, and 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."

Although he now focuses on population health, Dr. Marcozzi is an himself, and works one or two days a week in the University of Maryland Medical Center , treating .

This is the first study to quantify the contribution of emergency department care to overall U.S. health care. The paper appears in the latest issue of International Journal for Health Services.

For this study, Dr. Marcozzi and his colleagues examined publicly available data from several national healthcare databases, which covered all 50 states and the District of Columbia. They studied the period between 1996 and 2010.

For 2010, the most recent your study, the study found that there were nearly 130 million emergency department visits, compared with almost 101 million outpatient visits and nearly 39 million inpatient visits. Inpatient visits typically involve a hospital stay, but are planned ahead, as opposed to emergency department visits, which are generally at least somewhat unexpected.

Over the 14-year period of the study, more than 3.5 billion health care contacts - emergency department visits, outpatient visits, and hospital admissions took place. Over that time, emergency care visits increased by nearly 44 percent. Outpatient visits accounted for nearly 38 percent of contacts. Inpatient care accounted for almost 15 percent of visits.

Certain groups were significantly more likely to use the emergency department as their method of healthcare. African-American patients were significantly more likely to have emergency department visits than patients in other racial groups; patients in the "other" insurance category, which includes those without any type of insurance, were significantly more likely to have emergency department visits than any other group. And patients living in the South were significantly more likely to have emergency department visits than patients living in other areas of the country.

African-American patients used emergency departments at a higher rate than other groups. In 2010, this group used the emergency department almost 54 percent of the time. The rate was even higher for urban African-American patients, who used emergency care 59 percent of the time that year. Emergency department use rates in south and west were 54 percent and 56 percent, respectively. In the northeast, use was much lower, 39 percent of all visits.

Certain groups accounted for increasing percentages of overall emergency room use: African-Americans, Medicare and Medicaid beneficiaries, residents of the south and west, and women. Dr. Marcozzi says that these findings point to increasing use by vulnerable populations, which is no surprise since socioeconomic and racial inequality creates barriers to the use health care.

The use of emergency care resources for non-emergency cases has been controversial, since initial patients often end up being seen for non-emergency medical issues. Some experts argue that emergency departments are covering for deficiencies in inpatient and outpatient resources, and for a lack of effective prevention strategies. This could contribute to the high rate of emergency department use. They argue that use should be reduced.

Dr. Marcozzi says this is unlikely to happen anytime soon, given the structure of the country's care system. He also notes that it may not be the best option. Instead, he says we should work to connect the care delivered in emergency departments with care delivered by the rest of the healthcare system.

Explore further: Alcohol abuse, dental conditions and mental health found to be causes of avoidable US emergency visits

Related Stories

Alcohol abuse, dental conditions and mental health found to be causes of avoidable US emergency visits

August 31, 2017
A recent study published in the International Journal for Quality in Health Care found that 3.5% of all emergency department visits analysed were 'avoidable'. Of these, the top 3 discharge diagnoses were alcohol abuse, dental ...

Low health literacy is associated with preventable emergency department visits

August 31, 2017
Low health literacy is a risk factor for potentially preventable emergency department (ED) visits, particularly those that result in hospital admission. That is the primary finding of a study to be published in the September ...

Does the affordable care act impact patient visits in the emergency department?

July 24, 2017
As the debate surrounding the Affordable Care Act (ACA) looms in the U.S. Congress, Johns Hopkins researchers are weighing in on one aspect of the law. In 2014, as part of the ACA, Maryland was one of the states that expanded ...

QI initiative cuts health care use in children with epilepsy

January 23, 2017
(HealthDay)—A quality improvement (QI) initiative can reduce emergency department and health care utilization for children with epilepsy, according to a report published online Jan. 20 in Pediatrics.

Medicaid expansion states saw ER visits go up, uninsured ER visits go down

June 19, 2017
States that expanded Medicaid coverage under the Affordable Care Act (the ACA) saw 2.5 emergency department visits more per 1,000 people after 2014, while the share of emergency department visits by the uninsured decreased ...

ERs can improve population health in rural areas

August 10, 2017
Emergency physicians in Michigan propose a new health care delivery model for rural populations that depends on a partnership between emergency medicine and primary care and seeks to reverse the trend of failing health in ...

Recommended for you

Why teens need up to 10 hours' sleep

February 21, 2018
Technology, other distractions and staying up late make is difficult, but researchers say teenagers need to make time for 8-10 hours of sleep a night to optimise their performance and maintain good health and wellbeing.

Electronic health records don't reduce administrative costs

February 21, 2018
The federal government thought that adopting certified electronic health record systems (EHR) would reduce administrative costs for physicians in a variety of specialties. However, a major new study conducted by researchers ...

Low-fat or low-carb? It's a draw, study finds

February 20, 2018
New evidence from a study at the Stanford University School of Medicine might dismay those who have chosen sides in the low-fat versus low-carb diet debate.

Tobacco kills, no matter how it's smoked: study

February 20, 2018
(HealthDay)—Smokers who think cigars or pipes are somehow safer than cigarettes may want to think again, new research indicates.

Just a few minutes of light intensity exercise linked to lower death risk in older men

February 19, 2018
Clocking up just a few minutes at a time of any level of physical activity, including of light intensity, is linked to a lower risk of death in older men, suggests research published online in the British Journal of Sports ...

Women who clean at home or work face increased lung function decline

February 16, 2018
Women who work as cleaners or regularly use cleaning sprays or other cleaning products at home appear to experience a greater decline in lung function over time than women who do not clean, according to new research published ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.