The number of visits to U.S. emergency departments increased by more than 23%, from 94.9 million in 1997 to roughly 116.8 million in 2007, according to a new study conducted by UC-San Francisco researchers and published in the Journal of the American Medical Association, the San Francisco Chronicle reports (Colliver, San Francisco Chronicle, 8/11).
The study was funded by the Agency for Healthcare Research and Quality, the California HealthCare Foundation, the National Institutes of Health and the Robert Wood Johnson Foundation. CHCF is the publisher of California Healthline.
Study Findings
According to the researchers, half of the increase in ED visits can be attributed to the growth of the U.S. population. Meanwhile, the increase in ED visits occurred while the total number of EDs decreased by 5%, from 4,114 in 1997 to 3,925 in 2007 (Kaplan, "Booster Shots," Los Angeles Times, 8/10).
Because the data used end in 2007, the study does not consider the impact of the economic recession, which might have caused an additional increase in ED visits, as more workers lost employer-provided insurance (San Francisco Chronicle, 8/11)
The study also found that as ED volume increased, the median wait time rose from 22 minutes to 33 minutes during the study period (Reinberg, HealthDay/Bloomberg Businessweek, 8/10).
Medicaid as Possible Contributing Factor
The research suggested that Medicaid played a large role in the increase in ED visits. The number of ED visits by Medicaid beneficiaries increased from 9.6 million in 1997 to 17.7 million in 2007, and the rate at which adult Medicaid beneficiaries visited EDs increased from 694 visits per 1,000 beneficiaries in 1999 to 947 visits per 1,000 beneficiaries in 2007 (San Francisco Chronicle, 8/11).
That rate was 3.5 times higher than the rate for privately insured adults in 1999. By 2007, the rate for adult Medicaid beneficiaries was five times higher than the rate for adults with private insurance (HealthDay/Bloomberg Businessweek, 8/10).
Medicaid gained about 4.8 million adult beneficiaries during the study period, which could account for some of the increase, the researchers said ("Booster Shots," Los Angeles Times, 8/10).
Ning Tang -- an assistant clinical professor at UCSF and lead author of the study -- said many of the Medicaid visits were for conditions that could have been managed in primary care clinics.
However, Angela Gardner, president of the American College of Emergency Physicians, said no one group was wholly responsible for the increase in ED visits. "The fact of the matter is people are sicker than they used to be, they're older than they used to be and have more illnesses than they used to have," she said (San Francisco Chronicle, 9/11).