In the Center for Disease Control and Prevention’s latest review of our nation’s health, they discovered that nearly 63 million Americans, one fifth of our population, visited the Emergency Department at least one time in 2011.
The report revealed that the total number of ED visits increased by 34% in the 15 years between 1995 and 2010. In 2010, emergency departments saw 130 million visits. The report did not state visit totals for 2011, but did state that seniors over 74 years old were the most frequent visitors, followed by children under the age of six (27%/24%) (link).
These numbers suggest that people are depending more heavily on EDs, but so are primary care doctors, who more and more are instructing their patients to go to the ED when they need immediate help outside of their office hours.
The CDC also reported:
- In 2009-10, 81% of ED patients were discharged for follow-up care; 16% were admitted to the hospital; 2% left before completing their visit, and less than 1% of visits ended in death.
- Of the many millions of people who visited the emergency department at least once in 2012, more had Medicaid coverage that private insurance or none at all.
- The majority of adults who visit the ED are seeking treatment for injuries.
- Between 2000 and 2010, CT scan and MRI use increased from 5% to 17% of visits. In 2010, x-rays were involved in 35% of emergency visits.
It has been pointed out that this spike in the use of CTs and MRI likely reflects an ever more complex patient population. It also illustrates an expectation among doctors and patients that injuries and ailments will be diagnosed right away in the ED. Furthermore, it’s commonly understood that the overall trend of increased diagnostic testing is a consequence of physicians trying to shield themselves from the risk of malpractice litigation.
Twenty four-hour access is another reason patients go to EDs. Another study suggests that when regular patients are unable to contact their primary doctor after hours, they are more likely to visit the ED than those who were able to reach their doctors after hours.
This increasing dependence on emergency departments, combined with the fact that there are less and less emergency departments nationwide, means more crowding and longer wait times. Between 1998 and 2000, people waited an average of 45 minutes to see a doctor, which increased to just under an hour between 2008 and 2010.
The price of emergency care increased as well. The CDC reported that costs rose 77% in the decade from 2000 to 2010. In that time, the average cost of an ED visit that did not end in hospitalization increased from $546 to $969. However, they also reported that emergency department care constitutes just 4% of total health care expenses in the U.S.
What does this increase in emergency department visits mean to you and your medical facility?
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