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Injuries account for a nearly one-third of pediatric emergency department visits

Nearly one-third of emergency department (ED) visits (more than 1.5 million) were for pediatric injuries in 2003, according to a study of 14 states. Nationally, 5.4 percent of children had an injury-related ED visit, and about $2.3 billion was spent on outpatient injury-related ED visits that year. Infants, adolescents, children from very low-income communities, and children from rural areas were more likely to have an injury-related ED visit than their peers. Although patient characteristics were fairly consistent across States, admission rates and expected source of payment for injury-related ED visits varied considerably by State.

Hospital admission rates ranged from 1.5 to 4.4 percent of injury-related ED visits and expected payer estimates ranged from 37.1 to 71.0 percent of visits billed to private insurance, 17.9 to 47.0 percent billed to Medicaid, and 2.1 to 10.4 percent billed to the uninsured. This variation suggests several opportunities to improve emergency care for injured children, note Pamela L. Owens, Ph.D., Marc W. Zodet, M.S., Terceira Berdahl, Ph.D., and Denise Dougherty, Ph.D., of the Agency for Healthcare Research and Quality (AHRQ). They and fellow investigators retrospectively analyzed data from the 2003 State Emergency Department Databases and State Inpatient Databases of AHRQ's Healthcare Cost and Utilization Project and Medical Expenditure Panel Survey. They examined patient and injury characteristics and hospital admission status by age, injury severity, and expected payer. The researchers call for studies on the relationships among State programs, policies, and care system characteristics and the nature and outcomes of injury-related ED care.

More details are in "Annual report on health care for children and youth in the United States: Focus on injury-related emergency department utilization and expenditures," by Dr. Owens, Mr. Zodet, Dr. Berdahl, and others, in the July-August 2008 Ambulatory Pediatrics 8(4), pp. 219-240.

Reprints (AHRQ Publication No. 08-R082) are available from the AHRQ Publications Clearinghouse.

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