National Hospital Ambulatory Medical Care Survey: 2003 emergency department summary

Abstract

Objectives—This report describes ambulatory care visits to hospital emergency departments (EDs) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in ED utilization from 1993 to 2003 are also presented. Methods—The data presented in this report were collected in the 2003 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. Results—During 2003, an estimated 113.9 million visits were made to hospital EDs, about 38.9 visits per 100 persons. From 1993 to 2003, increasing trends in ED utilization rates were observed for people ages 22–49 years, 50–64 years, and 65 years and over. Over 16 million patients arrived by ambulance (14.2 percent). At approximately 3 percent of visits, the patient had been seen in the ED within the past 72 hours. In 2003, abdominal pain, chest pain, fever, and cough were the leading patient complaints, accounting for nearly one-fifth of all visits. Acute upper respiratory infection was the leading illness-related diagnosis at ED visits. There were an estimated 40.2 million injury-related visits during 2003, or 14.1 visits per 100 persons. Diagnostic and screening services, procedures, and medications were provided at 89.7 percent, 45.4 percent, and 77.3 percent of visits, respectively. In 2003, approximately 14 percent of ED visits resulted in hospital admission. On average, patients spent 3.2 hours in the ED, of which 46.5 minutes were spent waiting to see a physician.