Skip Navigation

Trends in Emergency Department Visits

Initial Selection:
Compare to:
graphic depiction of National Trends ED data which is available immediately following this image.
U.S. National: Number of ED Visits Overall
Year All ED visits
2008 124,945,264
2009 128,885,040
2010 128,970,364
2011 131,048,605
2012 134,399,179
2013 134,869,015
2014 137,807,901
2015 143,469,670
2016 144,842,742
2017 144,814,803

Emergency Department Visits

The national estimates presented in this section of Fast Stats are from the HCUP Nationwide Emergency Department Sample (NEDS). The NEDS is the largest all-payer emergency department (ED) database in the United States, yielding national estimates of hospital-owned ED visits. Hospital-owned EDs are limited to community hospitals, which are defined as short-term, non-Federal, general, and other hospitals, excluding hospital units of other institutions (e.g., prisons). The NEDS includes specialty, pediatric, public, and academic medical hospitals. Excluded are long-term care facilities such as rehabilitation, psychiatric, and alcoholism and chemical dependency hospitals.

The NEDS is sampled from the HCUP State Emergency Department Databases (SEDD), which capture information on ED encounters that do not result in an admission (i.e., treat-and-release visits and transfers to other hospitals), and the HCUP State Inpatient Databases (SID), which contain information on patients initially seen in the ED and then admitted to the same hospital. The NEDS approximates a 20 percent stratified sample of U.S. hospital-owned EDs. The NEDS is stratified on the following hospital characteristics: U.S. Census region, trauma center designation, urban-rural location of the hospital, ownership, and teaching status. The NEDS is currently available for data years 2006-2017. Since the initial release of the NEDS, State participation has grown from 24 States in 2006 to 36 States and the District of Columbia in 2017.

Unit of Analysis

The unit of analysis is an ED visit, not a person or patient. This means that a person who visits the ED multiple times in one year is counted each time as a separate visit in the ED. Counts are summarized by discharge year. Transfers to another acute care hospital or ED are included.

ED Visit Types

Three ED visit types are reported in this section of Fast Stats.

All ED visits

Includes treat-and-release ED visits and ED visits resulting in admission to the same hospital.

Treat-and-release ED visits

Includes ED visits that did not result in admission to the same hospital and ED visits transferred to another hospital or ED.

ED visits resulting in admission to the same hospital

Includes ED visits for patients initially seen in the ED and then admitted to the same hospital.

Rate of ED Visits per 100,000

Population-based rates are presented for ED visit trends overall and by age, sex, community-level income, and patient location. Population-based rates are not reported by expected payer because currently there is no data source of national population insurance estimates that aligns with HCUP's definition of expected primary payer. The rate of ED visits includes the HCUP number of ED visits in the numerator and the U.S. resident population in the denominator (with a multiplier of 100,000). For all characteristics, the denominator is consistently defined with the numerator (i.e., rates for females use HCUP counts and population counts specific to females). Population data are obtained from Claritas, a vendor that produces population estimates and projections based on data from the U.S. Census Bureau. Claritas estimates intercensal annual household and demographic statistics for geographic areas.

Age

Age refers to the age of the patient at admission to the ED. ED visits missing age are excluded from results reported by age.

Sex

All nonmale, nonfemale responses are set to missing. ED visits with missing values for sex are excluded from results reported by sex.

Expected Payer

The "expected payer" data element in HCUP databases provides information on the type of payer that is expected to be the source of payment for the ED bill. Information is reported by the following expected primary payers: Medicare, Medicaid, private insurance, and self-pay/no charge. Patients identified as self-pay/no charge have an expected primary payer of self-pay, no charge, charity, or no expected payment. More information on expected payer coding in HCUP data is available in HCUP Methods Series Reports by Topic "User Guide - An Examination of Expected Payer Coding in HCUP Databases" (multiple documents; updated annually). ED visits missing expected payer are excluded from results reported by expected payer.

ED visits with the following expected primary payers are not reported in Fast Stats reporting by expected payer for national trends in ED visits: other Federal, State, and local programs; missing; or invalid. In 2016, these excluded ED visits represented 4 percent of all ED visits.

The total reflecting the number of ED visits across all expected payers (including those groups not presented in the graphs) is provided in the underlying data tables ("Show Underlying Data Tables") by expected payer by ED visit type. These totals are the same as the counts obtained for the overall characteristic selection for the respective ED visit type.

For comparison against the total described above for all expected payers, the Excel download file also provides the sum of the displayed expected payers (i.e., the sum of the expected payer counts of ED visits across the expected payers that are displayed in the graphs).

Community-Level Income

Community-level income is based on the median household income of the patient's ZIP Code of residence. Quartiles are defined so that the total U.S. population is evenly distributed across four groups. The cut-offs for the quartile designation are determined annually using ZIP Code demographic data obtained from Claritas, a vendor that produces population estimates and projections based on data from the U.S. Census Bureau. Claritas estimates intercensal annual household and demographic statistics for geographic areas. The value ranges for the national income quartiles vary by year. Income quartile is missing if the patient is homeless or foreign. ED visits missing the income quartile are excluded from results reported by community-level income.

Patient Location

Patient location is based on the six-category, county-level scheme developed by the National Center for Health Statistics (NCHS) to study the relationship between urbanization and health:

  • Large central metropolitan: Counties in metropolitan statistical areas (MSAs) of 1 million or more population that contain the entire population of the largest principal city of the MSA, have their entire population contained in the largest principal city of the MSA, or contain at least 250,000 inhabitants of any principal city of the MSA
  • Large fringe metropolitan (suburbs): Counties in MSAs of 1 million or more population that did not qualify as large central metropolitan counties
  • Medium metropolitan: Counties in MSAs of populations of 250,000 to 999,999
  • Small metropolitan: Counties in MSAs of population less than 250,000
  • Micropolitan: Counties in micropolitan statistical areas
  • Noncore: Nonmetropolitan counties that did not qualify as micropolitan
In the NCHS scheme, the rural counties are divided into micropolitan and noncore categories, but in this section of Fast Stats, these two categories are combined into a single rural category in order to preserve results when cell sizes are too small. For rates prior to 2014, the NCHS classification is based on population density from the 2000 Census. Starting in 2014, the NCHS classification is based on population density from the 2010 Census. ED visits missing patient location are excluded from results reported by patient location.

Use this export feature to download all of the underlying data for national trends in ED visits (all measures and characteristics) in Microsoft Excel (.xls) format.

  1. Select Excel Export to request the download.
  2. You must read and agree to the terms of the Data Use Agreement for HCUP Fast Stats that is displayed on the screen in order to obtain these data.
  3. Follow the prompts to save a copy of the Excel file to your computer. Prompting will vary by browser.
  4. If you decide to use these data for publishing purposes please refer to Requirements for Publishing with HCUP Data.


Internet Citation: HCUP Fast Stats. Healthcare Cost and Utilization Project (HCUP). July 2020. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/faststats/national/inpatienttrendsED.jsp.
Are you having problems viewing or printing pages on this Website?
If you have comments, suggestions, and/or questions, please contact hcup@ahrq.gov.
Privacy Notice, Viewers & Players
Last modified 7/8/2020