Epidemiologic patterns of injuries treated in ambulatory care settings.
OBJECTIVE
Epidemiologic studies of injury morbidity have relied primarily on data from emergency departments (EDs) and hospital admissions. We seek to assess the incidences and characteristics of acute injuries treated at EDs and other ambulatory care settings.


METHODS
Using data from the 2002 National Health Care Survey on initial visits for acute injuries to EDs, physician offices, and hospital outpatient departments, we estimated the frequencies and incidence rates of medically attended injury by patient characteristics and care setting.


RESULTS
In the United States in 2002, 76 million nonfatal acute injuries received initial medical attention at EDs (46.2%), physician offices (47.8%), and outpatient departments (6.0%). The overall annual incidence rate of medically attended injury was 26.8 per 100 population (95% confidence interval 24.4 to 29.7). Falls accounted for 16.7% of all medically attended injuries. Injury patients who were black or uninsured were significantly more likely to visit EDs than other care settings for treatment. More than 2.4 million (3.2%) injury patients were admitted to hospitals, 96.6% of them through EDs.


CONCLUSIONS
Fewer than half of all medically attended acute injuries in the United States receive initial treatment in EDs. Injury severity and characteristics vary among care settings.
Betz
Marian E
ME
Johns Hopkins University School of Medicine, Baltimore, MD, USA. mbetz@bidmc.harvard.edu
Li
Guohua
G
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D044383:Black People / Q000706:statistics & numerical data; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010824:Physicians' Offices / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*; D001741:Black or African American