Emergency department visits

Estimate 136 million annual visits to the ED.

Between 1997 and 2007 ED visits increased almost twice as much as expected from population growth.

Represents at least 5-6% of US healthcare expenditures.

There are nearly 1,000,000 ED visits per upper tract stone disease per year.

Medicaid spends 23-47,000,000,000 annually for ED care.

Insured and uninsured adults use the ED at very similar rates and in very similar circumstances.

The uninsured use the ED substantially less than the Medicaid population.

The uninsured do not use the ED more than the insured, they do use other types of care much less than the insured.

Between 1997 in 2007 total annual visits to the emergency departments increased by 23%, corresponding to an estimated 21 million additional visits nationwide.

The above information suggests that the rate of growth of emergency department visits is twice the rate of growth of the US population over that time.

More than half of ED visits are unnecessary.

Approximately 20% of adults who seek emergency care will be hospitalized and the rest will be treated and discharged.

5 to 7% of patients presenting to an emergency department have an acute abdominal pain.

ED visits for patients who have had suicidal thoughts, harmed themselves or both is up 25.5% in the last two years.

Return emergency department visits range from 7.5-22% between three and 30 days.

Crowded EDs increase risk of patients with serious illnesses having delayed treatment.

Chest pain accounts for approximately 5-10% of ED visits.

About 8 million patients present to the emergency room each year with chest pain.

Only 10% of patients presenting to ED with chest pain have an acute MI.

Approximately 387,000 patients per year present with eye injuries and children represent up to 1/3 of those injured.

Low back pain is responsible for 2.4% of emergency department visits resulting in 2.7 million visits annually.

Most patients presenting to an emergency department for chest pain have a non-cardiac etiology.

Risk of missing acute coronary syndrome is increased in women presenting to the ED.

Long term prognosis of low-risk women presenting to the ED with chest pain is excellent.

Omission of predischarge cardiac testing in low-risk women presenting with chest pain is safe, accurate and decreases length of stay.


In the low-to-intermediate risk patients with suspected acute coronary syndrome, an 
undetectable hi sensitive troponin T value admission allows a safe discharge without 
occurrence of death myocardial infarction within 90 days (Vafaie M et al).

After introduction of the hs-troponin test in emergency departments there is a decrease in the overall invasive and noninvasive diagnostic testing for chest pain.


Patients with symptoms suggestive of an acute myocardial infarction count for approximately 10% of emergency department consultations.

ED care remains expensive, does not provide adequate preventive care, does not facilitate continuity of care.

Between 10-20% of children visits involve extremity injury and more than 90% of these injuries require radiographic studies.

Dental complaints of tooth pain or injury averages more than 738,000 visits annually in the U.S.

Patients with AMI inappropriately sent home from an emergency department have approximately a two fold higher risk adjusted thirty-day mortality then for those patients hospitalized (Pope JH et al).

Approximately 2% of patients presenting with myocardial infarction are inappropriately discharged from the ED.

In a study on patients presenting to the emergency department for dizziness, 5% had serious neurological diseases, most of which were acute cerebrovascular events (Navi BB et al).

In the above most cases are due to benign conditions such as peripheral vertigo, orthostatic hypotension and uncharacterized processes.

Insulin is one of the most commonly implicated drugs resulting in adverse events treated in emergency departments.

Insulin related hypoglycemic events account for one of every estimated EV visits for adverse events among the elderly, 80 years or older.

Hospitalization rates for insulin related hypoglycemic events are 2-5 times higher in patients 80 years or older than for those 45-64 years.

Individuals 85 years or older are twice as likely to experience a hypoglycemic related hospitalization than individuals 65-74 years.

Rehospitalizations and deaths are more frequent among adults 66 years, with at least one episode of hospitalized hypoglycemia.


The most frequent medication types and intent of use associated with emergency department visits attributed to medication harms are therapeutic use of anticoagulants, diabetes agents, benzodiazepines,prescription opioids, and therapeutic antibiotics.

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