Emergency departments provide nearly half of medical care in the U.S., study finds

Doctor and nurses wheeling patient in gurney through hospital corridor
Although hospitals have been trying to discourage patients from using the ER for nonemergency cases, a new study suggests healthcare leaders may want to reconsider that approach. (Getty/Sam Edwards)

New research highlights the major role that emergency departments play in U.S. healthcare.

The study, published in the International Journal of Health Services, finds that ERs provide nearly half of all medical care in the country.

Researchers from the University of Maryland School of Medicine (UMSOM) analyzed publicly available data between 1996 and 2010 from several national healthcare databases and determined that ERs contributed an average of 47.7% of the medical care delivered in the U.S. This percentage increased steadily over the 14-year study period.

"I was stunned by the results. This really helps us better understand healthcare in this country. This research underscores the fact that emergency departments are critical to our nation's healthcare delivery system," David Marcozzi, M.D., an associate professor in the UMSOM Department of Emergency Medicine, and co-director of the UMSOM Program in Health Disparities and Population Health, said in a study announcement. "Patients seek care in emergency departments for many reasons. The data might suggest that emergency care provides the type of care that individuals actually want or need, 24 hours a day."

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Over the 14-year period of the study, more than 3.5 billion healthcare contacts were made in the ER, outpatient facilities and hospitals. Over that time, emergency care visits increased by nearly 44%. Outpatient visits accounted for nearly 38% of contacts. Inpatient care accounted for almost 15% of visits.

Certain groups accounted for increasing percentages of overall ER use: African-Americans, Medicare and Medicaid beneficiaries, residents of the south and west, and women.

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Marcozzi said that these findings point to increasing use of the ER by vulnerable populations, which is no surprise since socioeconomic and racial inequality creates barriers to the use of healthcare.

Although hospitals have been trying to discourage patients from using the ER for nonemergency cases, Marcozzi said healthcare leaders may want to reconsider that approach given the current structure of the country's healthcare system. Instead, he suggested the industry may want to include emergency care within health reform and population health efforts.