Nearly Half of All Medical Care in the US Is in Emergency Departments
Emergency department use in the US now accounts for half of all medical care provided and is critical to health care delivery in the nation according to a recent study by the University of Maryland School of Medicine. The researchers focused on data from 1996 to 2010 and the 3.5 billion health care interactions that took place during this time relating to emergency department visits, hospital admissions, and outpatient visits. In 2010 there were a total of 39 million inpatient visits, 101 million outpatient visits, and 130 million emergency department visits, a rise of 44 percent over the course of the 14-year study. These increases in the use of emergency room cases can be accounted for by the groups most likely to use the service. Primarily this included women, African Americans, Medicare and Medicaid enrollees, as well as residents from the South and West. In addition to this, the research also demonstrated that there were significant demographic distinctions in the use of emergency care. Alongside those classed as being without any type of health insurance, African Americans were the most likely to use the emergency department and the authors believe that their statistics indicate that health care inequalities impact primarily upon the most vulnerable populations. A key recommendation of the paper is that more should be done to connect the care services offered in emergency departments with care delivery systems across the rest of the health network.

The percentage of care delivered in emergency departments has increased with nearly half of all medical care in the United States occurring there, according to a study.

Researchers at the University of Maryland School of Medicine (UMSOM) were able to quantify the contribution of emergency department care in reference to overall US healthcare. The study examined public data from 1996 to 2010 from national health databases. A paper explaining the findings was published in the International Journal for Health Services.

For 2010, the researchers found that there were nearly 130 million emergency department visits, while there were 101 million outpatient visits and almost 39 million inpatient visits. Throughout the full 14-year study period, 3.5 billion healthcare contacts occurred—emergency department visits, outpatient visits, and hospital admissions. The emergency care visits increased by nearly 44% during that time.

“I was stunned by the results," 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, said in a statement. "This really helps us better understand health care in this country. This research underscores the fact that emergency departments are critical to our nation’s healthcare delivery system."

The study also noted that certain demographics were more likely to use the emergency department for healthcare. African American patients and those who were considered “other” for their health insurance category—such as those without any type of insurance—were found to be significantly more likely to use the emergency department.

The increase in emergency room cases were able to be accounted for by certain groups including African Americans, Medicare and Medicaid beneficiaries, residents of the South and West, and women. The authors suggested that this further reveals the vulnerable populations that potentially face healthcare inequalities.

“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,” Marcozzi said.

The paper recommends working to connect the care delivered in emergency departments with the level of delivered care in the rest of the healthcare system.