Emergency Department Utilization
In 2008, more than 20 percent of children had at least one visit to a hospital emergency department (ED). Children living in households with incomes below the U.S. Census Bureau’s poverty threshold ($22,025 for a family of four in 2008) were more likely than children living in households with incomes above the poverty threshold to have visited the ED. Just over one quarter of children living in poverty made one to three ED visits during the year, compared to fewer than 20 percent of children living in households with incomes above poverty. Similarly, 3.0 percent of children from lower-income households made four or more visits to the ED, compared to 1.0 percent of children from higher-income households.
Emergency department utilization also varies by age: 26.6 percent of children under 5 years of age made 1–3 visits to the ED in 2008, compared to 15.4 percent of children aged 10–14 years. Children under 5 years of age were also the most likely to make four or more ED visits (2.1 percent). There were also racial/ethnic differences in ED utilization: 23.3 percent of non-Hispanic Black children made 1–3 visits to the ED in 2008, compared to 19.8 percent of Hispanic children and 18.9 percent of non- Hispanic White children (data not shown).
According to the 2006 National Hospital Ambulatory Medical Care Survey, the most common reason for a visit to the emergency department among children under 15 years of age was fever (15.1 percent), followed by cough (6.6 percent), and vomiting (5.5 percent). The most common primary diagnoses treated in ED visits were acute upper respiratory infections (9.2 percent), otitis media (middle ear infection) and Eustachian tube disorders (6.6 percent), and fever of unknown origin (5.8 percent; data not shown).1
1 Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. National Health Statistics Reports, No. 7; 2008 Aug.↑