title: US emergency department use by children, 2001-2010.
abstract: OBJECTIVE
  Children commonly use emergency departments (EDs) for a variety of health care needs. We describe recent trends in US ED use by children.
  
  
  METHODS
  This is a cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey, a nationally representative sample of ED visits, and US Census data between 2001 and 2010. We examined demographic trends, visit characteristics, insurance status, disposition, hospital variables, diagnoses, reason for visit, and resource use among patients younger than 19 years. Linear regression was used to evaluate significance of trends.
  
  
  RESULTS
  Approximately one quarter of all ED visits was made by patients younger than 19 years. Emergency department visits by children increased 14.4% between 2001 and 2010 (P = 0.04); the rate of visits increased from 36.4 to 40.6 per 100 population. Trauma is the most common reason for pediatric ED visits. Black children had the highest rate of ED use (61.9 per 100 in 2010). Visit rates by Hispanic children were relatively low but increased by 82.7% since 2001 (P = 0.00). The proportion of ED visits by Medicaid beneficiaries rose from 32.0% to 51.9% (P = 0.00). The volume and frequency of diagnostic testing, administration of intravenous fluids, medication administration, and discharge prescriptions increased. Visits with computed tomography or magnetic resonance imaging almost doubled from 3.1% of the visits in 2001 to 6.6% of the visits in 2010 (P = 0.00).
  
  
  CONCLUSIONS
  The use of ED by children is growing faster than population growth, and the intensity of ED care has risen sharply. Hispanic children and Medicaid beneficiaries represent the fastest growing populations of children using the ED.
authors.affiliation: From the Schools of *Medicine and Health Sciences, and †Public Health and Health Services, The George Washington University, Washington DC; and ‡The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Irit R
authors.initials: IR
authors.lastname: Rasooly
authors.forename: Peter M
authors.initials: PM
authors.lastname: Mullins
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Alpern
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D008297:Male; D044469:Racial Groups; D014481:United States