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Emergency Department Utilization

Narrative

In 2009, more than 20.8 percent of children had at least one visit to a hospital emergency department (ED). Children living in households with incomes below the U.S. Census Bureau’s poverty threshold ($21,954 for a family of four in 2009) were more likely than children living in households with incomes above the poverty threshold to have visited the ED in the past year. One-quarter of children living in poverty made 1–3 ED visits during the year, compared to 18.5 percent of children living in households with incomes above poverty. Similarly, 2.2 percent of children from low-income households made four or more visits to the ED, compared to 1.0 percent of children from higher-income households.

Emergency department utilization also varies by age: 24.5 percent of children under 5 years of age made 1–3 visits to the ED in 2009, compared to 17.6 percent of children aged 15–17 years. Children under 5 years of age were also the most likely to make four or more ED visits (2.3 percent). There were also racial/ethnic differences in ED utilization: 24.6 percent of non-Hispanic Black children made 1–3 visits to the ED in 2009 compared to 19.0 percent of Hispanic children and 18.8 percent of non- Hispanic White children.

According to the 2007 National Hospital Ambulatory Medical Care Survey, the most common reason for a visit to the emergency department among children under 15 years of age was fever (15.8 percent), followed by cough (6.1 percent), and vomiting (6.7 percent). The two most common primary diagnoses treated in ED visits among both males and females were acute upper respiratory infections (9.8 percent, combined), otitis media (middle ear infection) and Eustachian tube disorders (7.0 percent, combined), followed by unspecified viral and chlamydial infection among females (2.3 percent) and open wound of head (2.9 percent) among males.1

1 Niska RW, Bhuiya F, Xu J. National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary. National Health Statistics Reports, No. 26; 2010.

Graphs

This image is described in the Data section.

visits to the emergency room by poverty graph

This image is described in the Data section.

visits to the emergency department by age graph

Data

Visits to the Emergency Room Among Children Under Age 18, by Poverty,* 2009
Visits to ER Percent of children
Total Below poverty threshold Above poverty threshold
*The U.S. Census Bureau uses a set of money income thresholds to determine who is in poverty; the poverty threshold for a family of four was $21,954 in 2009.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. 2009 National Health Interview Survey. Unpublished data. Analyzed by the MCH Information Resource Center.
No visits 79.2 72.8 80.5
1-3 visits 19.6 25.0 18.5
4 or more visits 1.2 2.2 1.0
Visits to the Emergency Department Among Children Under Age 18, by Age, 2008
Number of visits to ER Percent of Children
Under 5 years 5-9 years 10-14 years 15-17 years
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. 2009 National Health Interview Survey. Unpublished data. Analyzed by the MCH Information Resource Center.
No visits 73.2 81.2 82.1 81.5
1-3 visits 24.5 17.9 17.3 17.6
4 or more visits 2.3 0.9 0.6 0.9

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