title: California emergency department visit rates for medical conditions increased while visit rates for injuries fell, 2005-11.
abstract: The emergency department (ED) is the source of most hospital admissions; provides care for patients with no other point of access to the health care system; receives advanced care referrals from primary care physicians; and provides surveillance data on injuries, infectious diseases, violence, and adverse drug events. Understanding the changes in the profile of disease in the ED can inform emergency services administration and planning and can provide insight into the public's health. We analyzed the trends in the diagnoses seen in California EDs from 2005 to 2011, finding that while the ED visit rate for injuries decreased by 0.7 percent, the rate of ED visits for noninjury diagnoses rose 13.4 percent. We also found a rise in symptom-related diagnoses, such as abdominal pain, along with nervous system disorders, gastrointestinal disease, and mental illness. These trends point out the increasing importance of EDs in providing care for complex medical cases, as well as the changing nature of illness in the population needing immediate medical attention.
authors.affiliation: Renee Y. Hsia (renee.hsia@emergency.ucsf.edu) is a professor in the Department of Emergency Medicine at the University of California, San Francisco.
authors.forename: Renee Y
authors.initials: RY
authors.lastname: Hsia
authors.affiliation: Julia B. Nath is a medical student at the University of Chicago Pritzker School of Medicine, in Illinois.
authors.forename: Julia B
authors.initials: JB
authors.lastname: Nath
authors.affiliation: Laurence C. Baker is a professor in health research and policy at Stanford University, in California, and a research associate at the National Bureau of Economic Research in Cambridge, Massachusetts.
authors.forename: Laurence C
authors.initials: LC
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000453:epidemiology; D003695:Delivery of Health Care; D004630:Emergencies / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data / Q000639:trends*; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
keywords: Medicine/Clinical Issues; Organization and Delivery of Care; Public Health
references.citation: Health Aff (Millwood). 2013 Oct;32(10):1811-9
references.pmid: 24101073
references.citation: JAMA. 2006 Oct 18;296(15):1858-66
references.pmid: 17047216
references.citation: Ann Emerg Med. 2011 Dec;58(6):551-558.e2
references.pmid: 21802775
references.citation: Health Aff (Millwood). 2009 May-Jun;28(3):w490-501
references.pmid: 19366722
references.citation: PLoS Med. 2007 Aug;4(8):e247
references.pmid: 17683196
references.citation: Ann Emerg Med. 2005 Oct;46(4):369-75
references.pmid: 16183394
references.citation: N Engl J Med. 2012 Dec 27;367(26):2465-7
references.pmid: 23268662
references.citation: Ann Emerg Med. 1994 Nov;24(5):849-56
references.pmid: 7978557
references.citation: Ann Emerg Med. 2001 Dec;38(6):675-83
references.pmid: 11719749
references.citation: Arch Gen Psychiatry. 1997 Nov;54(11):1038-43
references.pmid: 9366661
references.citation: NCHS Data Brief. 2012 Jul;(100):1-8
references.pmid: 23101759
references.citation: MMWR Morb Mortal Wkly Rep. 2005 Oct 7;54(39):991-4
references.pmid: 16208312
references.citation: JAMA. 2013 Sep 18;310(11):1181-3
references.pmid: 24045743
references.citation: N Engl J Med. 2005 Jun 16;352(24):2515-23
references.pmid: 15958807
references.citation: Ann Emerg Med. 1998 Dec;32(6):703-11
references.pmid: 9832668
references.citation: JAMA. 2010 Aug 11;304(6):664-70
references.pmid: 20699458
references.citation: Rand Health Q. 2013 Jun 1;3(2):3
references.pmid: 28083290