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Emergency Department Usage Trends Before COVID-19

By James J. Augustine, MD, FACEP | on May 21, 2020 | 0 Comment
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Key Planning Elements

There were approximately 450 ED visits per 1,000 people in 2017. High utilizers continued to include infants, nursing home residents, the homeless, blacks, and people over age 75. Persons over age 65 accounted for 15.8 percent of ED visits, and persons age 75 and older had 605 visits per 1,000 in 2016. A mere 4.3 percent of ED visits classified as nonurgent (the highest rates of these visits were for patients under age 15). Injuries accounted for an estimated 29 percent of ED visits, reflecting an ED population distribution that featured less injury and more illness.

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ACEP Now: Vol 39 – No 05 – May 2020

The leading cause of ED visits for injuries was falls. When viewed through the lens of “presenting complaint,” stomach and abdominal pain were the most common in 2017, accounting for around 9 percent of visits. Chest pain was next highest, at 5 percent. There continues to be an increasing presence of mental disorders noted in ED patients.

There is an ongoing increase in use of diagnostic tools in emergency departments, especially electrocardiograms. Use of computed tomography scanning appears to have plateaued, but the use of magnetic resonance imaging and other special imaging procedures (such as ultrasound) are increasing.

The ED Benchmarking Alliance performs a data survey that reports on ED performance measures. That data survey finds that roughly 69 percent of hospital inpatients are processed through the emergency department. This clearly demonstrates the emergency department has become the front door to the hospital.

Planning for the Future

The demand for emergency services has continued to rise, especially for patients who are older, sicker, and in need of high-level diagnostic services and hospital admission. And the current challenges of the coronavirus pandemic put the emergency department clearly in the spotlight as the responsible entity for crisis care.

However, the long-term volume growth in American emergency departments may be tempered by the use of telemedicine services that will grow tremendously in the coming months.

Regardless, emergency physicians must trumpet the emergency department’s value to hospital and community leaders so the improvements needed to deliver care in a safe and effective manner will be prioritized.

See the Data Yourself

All state-specific and national summary NEDI-USA data for 2017 can be found here.

Based on NEDI-USA data, the current locations of all U.S. emergency departments can be found in the free smartphone app EMNet findERnow. You can also use this app to find specific information about all U.S. emergency departments, including the specifications as a verified trauma or burn center.

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Topics: coronavirusCOVID-19DemographicsEmergency Department Visits

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About the Author

James J. Augustine, MD, FACEP

James J. Augustine, MD, FACEP, is national director of prehospital strategy for US Acute Care Solutions in Canton, Ohio; clinical professor of emergency medicine at Wright State University in Dayton, Ohio; and vice president of the Emergency Department Benchmarking Alliance.

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