OBJECTIVES:

The use of the emergency department (ED) by patients for non-urgent medical conditions has reportedly risen. However, the trend in recent times has not been studied. This study evaluates trends in emergency department visits to determine if non-emergent visits were increasing over time between 2013 and 2016

METHODS:

We obtained data from the National Hospital Ambulatory Care Survey (NHAMCS) which collects data on patient visits to EDs throughout the United States. We included all visits made to an ED during the period between January 1, 2013 and December 31, 2016. We defined two major triage categories - emergent and non-emergent. To evaluate the trend in non-emergent visits over time, we computed the standardized mean proportion of ED visits classified as non-emergent based on the triage category “non-urgent”. for each year. We also examined factors associated with non-emergent ED visit using multivariate logistic regression .

RESULTS:

Of 89,149 ED visits, the mean age of ED patients was 37 years, 55% were female, and 59% were non-Hispanic white, and 30% of sample visits were covered by Medicaid. Overall, the standardized mean proportion of non-emergent ED visits was 4.8%. Between the 2013 and 2016, the standardized mean proportion of non-emergent ED visits was 4.8%,4.9%, 4.9% and 4.8% respectively Males, and patients who reported no pain were more likely to be non-emergent (OR 1.21, 95% CI 1.08-1.35) and (OR 1.66, 95%CI 1.34-2.06) respectively. Patients with more chronic conditions are significantly less likely to be non-emergent (OR 0.44, 95%CI 0.29-0.67).

CONCLUSIONS :

In this nationally representative sample, while factors such as age, sex, pain scale and total chronic conditions were significantly associated with non-emergent ED visits ,only a small fraction of ED visits was triaged as non-emergent and the proportion has stayed steady over recent years.