Emergency visits climbed to a record high of 145.6 million patients in 2016, the most recent year available, according to new data from the Centers for Disease Control and Prevention (CDC).

This is an increase from more than 136.9 million visits in 2015. And, only 4.3 percent of emergency patients went to the emergency department with nonurgent medical symptoms, a decrease from 5.5 percent in 2015. Wait times continue to improve. More than one-third (39 percent) of patients wait less than 15 minutes to see a provider and nearly three-quarters (72 percent) of patients are seen in less than one hour.

After business hours

“Emergency physicians are uniquely qualified to provide essential care that patients can’t get anywhere else,” said Vidor Friedman, MD, FACEP, president of the American College of Emergency Physicians. “Nearly two-thirds of visits occur after business hours, when other doctors’ offices are closed. Millions of patients rely on emergency physicians for rapid diagnosis and treatment of acute illness, while emergency departments are increasingly viewed as a hub for care and care transitions.”

Illness continues to outpace injury as a reason people seek emergency care and the most frequently seen patients are children or senior citizens. Patients age 15 or younger made up 18.8 percent (27.4 million) of emergency visits. Patients age 65 or older made up 15.9 percent (23.1 million) of emergency visits.

Most common reasons

Stomach pain (12.5 million visits, 8.6 percent) and chest pain (7.5 million visits, 5.2 percent) top the list of the most common reasons patients seek emergency care. Injuries accounted for 42.2 million emergency visits (29 percent). The leading causes of injury were falls (10.5 million visits, 23 percent of injury visits) and motor vehicle crashes (3.7 million visits, 8.1 percent of total injury visits). Heart disease was the leading principal diagnosis group among the diseases that most commonly resulted in hospital admission from the emergency department.

Almost 60 percent of emergency care was delivered outside of traditional “business hours” (8am-5pm). And, 69 percent of hospital inpatients are processed through the emergency department. There was no change in the percentage of care delivered during traditional business hours (41 percent).

“Emergency physicians are proud to provide care to anyone, anytime,” said Dr. Friedman. “Emergency care is growing more complex and some of the larger trends that will impact emergency department planning and resource discussions include the rising number of elderly patients, preventing and treating opioid abuse, and the role of the emergency department in treating and managing patients with mental illness.”   

Other highlights:

• Median time to see a physician or other provider decreased to 17 minutes. The median visit length is about 180 minutes, which includes time with the physician or other provider, or other clinical services.
• In 2016, 15.8 percent of patients arrived at the emergency department by ambulance, representing about 24 million ambulance transports.
• Hospital admission or transfer resulted from 17.4 million visits. A patient admitted to the hospital from the emergency department will stay in the hospital an average of 4.5 days.
• There were 2.2 million emergency visits by patients living in nursing homes, one-third of which resulted in hospital admission.
• More than 5.5 million patients visited the emergency department with a primary diagnosis of mental disorder. Of those, 2.4 million visits involved a mental health professional seeing a patient in the emergency department. Patient visits resulting in hospital admission for mental health issues reached more than 2.1 million, which is 5,930 patient visits every day.
• The number of homeless patients increased from 0.6 percent to 1 percent of total emergency visits.
• The most frequent source of payment was Medicaid or CHIP (37.7 percent of visits), followed by private insurance (31.8 percent), Medicare (21.6 percent) or no insurance (8.4 percent). 

The CDC data does not include freestanding emergency departments or urgent care centers. The CDC National Hospital Ambulatory Medical Care Survey is available here.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.