OBJECTIVES

The objectives of this study were to describe the national trends in emergency department visits and associated charges in the United States (US) from 2010 to 2016.

METHODS

This was a retrospective analysis of ED visit data from the National Emergency Department Sample (NEDS) from 2010 through 2016. Visits were stratified by age, sex, payer, and diagnostic category. Survey analysis techniques accounted for clustering and stratification of the visits. The total annual ED visits and charges associated with the visit were reported. Further, the total ED visits and charges were reported for the top five diagnoses. Trends in ED utilization and charges over time were evaluated using variance-weighted regression.

RESULTS

Between 2010 and 2016, the number of US ED visits increased from 128.9 million to 144.8 million. The increase in ED visits was 12.31% and the compound annual growth rate (CAGR) was 1.95%. The overall population increased by 4.46% and the CAGR was 0.73%. The average charge per visit increased from $2,061 (SD $2,962, median $1,180) to $3,516 (SD $5,285; median $1,959; p <0.0001). The increase in charges was 70.63%, the CAGR was 9.31%, and the total estimate of ED charges was $509 billion in 2016. The top five reasons for an ED visit in 2016 were: abdominal problems (14.70 million); upper respiratory infections (URI) (6.59 million); chest pain (6.34 million); mental health and substance abuse (MH) (6.32 million); and superficial injury (5.55 million). The average charge per visit was $5,111 (SD $6,394; median $3,119) for an abdominal problem, $1,481 (SD $1,797; median $1,034) for an URI, $7,096 (SD $9,679; median $3,918) for chest pain; $3,116 (SD $3,478; median $2,251) for MH, and $2,715 (SD $4,205; median $1,451).

CONCLUSIONS

The economic burden associated with the increasing ED visits and charges may challenge the sustainability of the US healthcare system.