Trends in Hospital Emergency Department Visits by Age and Payer

Trends in Hospital Emergency Department Visits by Age and Payer, a statistical brief from the Healthcare Cost and Utilization Project, presents trends in hospital-affiliated emergency department (ED) utilization by examining the population rate of ED visits and the number of ED visits across primary payers by age groups.

The ED provides services to all who seek ED care, regardless of ability to pay, and the ED has become an important source of admissions for hospitals. Prior studies have shown that patients aged 18-44 years and 45-64 years accounted for the greatest increase in ED visits from 1997 to 2007, and the population ED visit rate increased significantly among adults with Medicaid. In 2011, one in five people reported visiting the ED at least once during the past year, and those with Medicaid coverage were more likely to visit the ED than those without insurance or those with private insurance. More recent studies have shown that policies that aim to reduce the number of patients without insurance can shift payer mix in the ED.

Highlights

• The rate of ED visits per 100,000 population reached a 10-year high in 2015 for all age groups and increased the most for patients aged 45-64 years (20 percent, from 2006).
• The proportion of ED visits that resulted in hospital admission decreased for all age groups from 2006 to 2015.
• For patients aged under 18 years, the share of ED visits with Medicaid as the primary payer rose from 45 percent in 2006 to 62 percent in 2015.
• The share of Medicaid among ED visits for those aged 18-44 and 45-64 years rose with an average annual increase of 11 and 14 percent, respectively, from 2013 to 2015, compared with a 4 percent increase for both age groups from 2006 to 2013.
• The share of uninsured ED visits for those aged 18-44 and 45-64 years dropped with an average annual decrease of 17 and 21 percent, respectively, from 2013 to 2015, compared with a 0 and 2 percent increase, respectively, from 2006 to 2013.
• For patients under the age of 65 years, the share of ED visits covered by private insurance decreased from 2006 to 2015 and changed the most for patients under age 18 years (average annual decrease of 4 percent).
• For those aged 65 years and older, Medicare and private insurance accounted for 95 to 96 percent of all ED visits.

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