Uninsured account for 20% of U.S. ER visits

Jul 15 2009

Health and Human Services Secretary Kathleen Sebelius today released new data from the Nationwide Emergency Department Sample -- the largest, all-payer emergency department database in the United States.

The Nationwide Emergency Department Sample is designed to help public health experts, policymakers, health care administrators, researchers, journalists and others find the data they need to answer questions about care that occurs in U.S. hospital emergency departments.

These data indicate that uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006. Low-income patients accounted for almost one-third, and residents of rural areas accounted for one-fifth of the visits.

"Our health care system has forced too many uninsured, rural and low-income Americans to depend on the emergency room for the care they need," said Secretary Sebelius. "We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies."

The database is managed by HHS' Agency for Healthcare Research and Quality (AHRQ) and generates national estimates on the number of emergency department visits in all community hospitals, by region, urban/rural location, teaching status, ownership and trauma designation. It also provides in-depth information on acute management of patients for all visits, including why patients were seen in the emergency department, the treatments they received, what happened to them at the end of the visit (admitted to the hospital, discharged home, transferred to another hospital, died in the emergency room or left against medical advice), the charge for their care and who was billed.

The Nationwide Emergency Department Sample contains 26 million records from emergency department visits from approximately 1,000 community hospitals nationwide. This represents 20 percent of all U.S. hospital emergency departments. The database also provides weighted calculations for national estimates of the 120 million ED visits in 2006.

"AHRQ has a long history of supporting health services research related to emergency medicine, and the richness of these new data will increase our capacity for research and decision making," said AHRQ Director Carolyn M. Clancy, M.D. "The new database will give emergency planners and other policymakers the data they need to help improve the quality, safety and effectiveness of emergency medical care."

AHRQ also released its latest Nationwide Inpatient Sample - the largest, most powerful database on hospital care in the United States, covering all patients, regardless of their type of insurance or whether they were insured. The 2007 Nationwide Inpatient Sample provides users with an in-depth look at why patients were hospitalized, the treatments and procedures they received and what happened to them at discharge. Researchers can use the Nationwide Inpatient Sample to examine trend data as far back as 1988. The 2007 Nationwide Inpatient Sample is based on discharge data from 8 million hospital stays at more than 1,000 community hospitals.

The two databases, as well as the 2006 Kids' Inpatient Database on pediatric inpatient care, are part of AHRQ's Healthcare Cost and Utilization Project (HCUP), a federal-state-industry partnership for building a standardized, multi-state health data system. In addition to databases, HCUP includes software tools and statistical reports to inform policymakers, health system leaders, researchers and the public.

HCUP databases can be accessed by using the AHRQ on-line query tool, HCUPnet (http://hcupnet.ahrq.gov/). Researchers and analysts who need the most in-depth data should contact the HCUP Central Distributor about purchasing the 2006 Nationwide Emergency Department Sample and the 2007 Nationwide Inpatient Sample datasets and for further information about their composition and technical requirements.