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Emergency Department Utilization

Narrative

In 2010, 22.0 percent of children had at least one visit to a hospital emergency department (ED) in the past year and 8.4 percent had multiple visits. Children younger than 5 years of age were more likely to have had a past-year ED visit (28.1 percent) than children aged 5–11 years or 12–17 years (20.4 percent and 19.0 percent, respectively; data not shown in graph images or in data tables on this site).

Emergency department utilization also varies by poverty and race and ethnicity. In 2010, almost one-third of children living in households with incomes below the poverty level had visited an ED in the past year (30.2 percent), compared to 17.3 percent of children living in households at 200 percent or more of the poverty level. Children in poverty were more than twice as likely to have had multiple ED visits as non-poor children living at 200 percent or more of poverty (13.2 versus 5.6 percent, respectively). With respect to race and ethnicity, non-Hispanic Black and Hispanic children were most likely to have visited an ED (26.9 and 23.1 percent, respectively) while Asian children were least likely to have done so (14.9 percent). Compared to the overall average, Asian children had a similar proportion of multiple ED visits but a lower proportion of single visits, whereas non-Hispanic Black children had a higher proportion of both single and multiple visits.

According to the 2009 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 (19.7 percent of visits), followed by cough (7.6 percent), and vomiting (4.5 percent).1 The three most common primary diagnoses treated in ED visits among both males and females were acute upper respiratory infections (10.8 percent, combined), fever of unknown origin (6.6 percent, combined), and otitis media (middle ear infection) and Eustachian tube disorders (5.1 percent, combined), followed by unspecified viral and chlamydial infection for females (3.2 percent) and open wound of head (4.1 percent) for males. Asthma ranked as the seventh most common diagnosis for males (3.4 percent) compared to the thirteenth most common diagnosis for females (1.9 percent, data not shown in graph images or in data tables on this site).1

1 National Center for Health Statistics. National Hospital Ambulatory Medical Care Survey: 2009 Emergency Department Summary Tables. Accessed: September 3, 2012.

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 Department in Past Year Among Children Under Age 18,* by Poverty Status,** 2010
Poverty Status Percent of children
One Visit Two or More Visits Any Visit/Total
*All estimates are age-adjusted.
**Poverty level, defined by the U.S. Census Bureau, was $22,314 for a family of four in 2010.
Source: Bloom B, Cohen RA, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2010. National Center for Health Statistics. Vital Health Stat 10(250). 2011.
Total 13.6 8.4 22.0
Less Than 100% of Poverty 17.0 13.2 30.2
100-199% of Poverty 15.3 10.0 25.3
200% of More of Poverty 11.6 5.6 17.3
Visits to the Emergency Department in Past Year Among Children Under Age 18,* by Race/Ethnicity,** 2010
Race/Ethnicity Percent of Children
One Visit Two or More Visits Any Visit/Total
*All estimates are age-adjusted.
**The sample of Native Hawaiian/Pacific Islander children was too small to produce reliable results.
Source: Bloom B, Cohen RA, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2010. National Center for Health Statistics. Vital Health Stat 10(250). 2011.
Non-Hispanic White 13.1 7.4 20.5
Non-Hispanic Black 14.8 12.2 26.9
Hispanic 14.8 8.3 23.1
Non-Hispanic American Indian/Alaska Native 13.4 6.3 19.7
Non-Hispanic Asian 7.7 7.3 14.9