Emergency room (ER) visits reached a record high of more than 136 million in 2011, compared with just under 130 million in 2010, according to new data released by the Centers for Disease Control and Prevention (CDC).
While the percentage of patients with non-urgent medical conditions dropped by half, an overwhelming 96 percent were triaged as needing medical treatment within two hours, up from 92 percent in 2010.
Experts project that ER visits are likely to increase to 140 million, given 10-year trends. An aging population, and increasing disasters and infectious disease outbreaks are contributing to the rise, which will continue in order to meet demand, say officials from the American College of Emergency Physicians (ACEP), which reprinted the report. But despite the growing need for emergency care, most hospitals have not expanded their emergency departments (EDs) as of 2011, nor had they made plans to expand in the subsequent two years.
According to a recent study by the Colorado Hospital Association, ER visits are up significantly in Medicaid expansion states. They saw a 5.6 percent increase in Medicaid emergency visits compared with the same period last year. Emergency departments in non-expansion states saw a 1.8 percent increase, possibly because people who were previously eligible for Medicaid were getting coverage and using emergency care more.
Other key findings from the CDC report include the following:
- More than half (60 percent) of patients arrived after normal business hours, or after 5 p.m. on weekdays.
- One-third of ER visits were for patients under 15 or over 65.
- Injuries accounted for nearly 30 percent (29.5 percent) of all visits.
- The highest injury rates were among those aged 75 and older.
- Nearly two-thirds of patients waited two or more hours for beds in 2011, and nearly three-quarters of hospitals continued to board patients, even when the ED was critically overloaded.
The report goes on to state that one-third (33 percent) of EDs went on ambulance diversion in 2011, and 17 percent of hospitals did not admit elective or scheduled surgical patients when the ED went on ambulance diversion. However, more than half of hospitals continued to admit elective or scheduled surgeries even when the ER was on diversion. A lack of flexibility in surgical schedules contributes to ED crowding, as it limits availability of inpatient beds, researchers note.
Even though these newly released figures from the CDC pre-date the implementation of the Affordable Care Act (ACA), there is already evidence that emergency visits are on the rise now. Nearly half of emergency physicians responding to an ACEP poll in April reported a rise in emergency visits since January 1 when expanded coverage under the ACA began to take effect. Nearly 90 percent expected emergency visits to increase over the next three years, and more than three-fourths (77 percent) said their ERs are not adequately prepared for significant increases.
Source: American College of Emergency Physicians (ACEP), November 20, 2014
2014 Healthcare Benchmarks: Reducing Avoidable ER Visits delivers actionable metrics from 125 healthcare organizations on their efforts to foster appropriate use of hospital emergency departments, and is enhanced with more than 50 easy-to-follow graphs and tables.