Emergency departments recorded 155.398 million visits in the United States in 2022, equal to 47.3 visits for every 100 people. These figures from the CDC National Hospital Ambulatory Medical Care Survey (NHAMCS) describe a broad mix of urgent symptoms, injuries, chronic conditions, and follow-up needs.
Contents
- Emergency department use at a glance
- Who uses emergency care
- Why people visit
- Triage and clinical measurements
- What happens after arrival
- Chronic conditions and medication patterns
- Injuries among older adults
Emergency department use at a glance
The 2022 national total provides the clearest starting point for understanding emergency room demand. The CDC NHAMCS 2022 Emergency Department Summary Tables report 155.398 million emergency department visits and a rate of 47.3 visits per 100 people. A visit count is not the same as the number of unique patients: one person can have more than one visit during a year.
Injury care represented a substantial share of activity. The CDC FastStats: Emergency Department Visits reports 43.5 million injury-related emergency department visits in 2022. This category includes poisoning and adverse effects of medical treatment. The same source reports 17.8 million visits resulting in hospital admission and 3.1 million resulting in admission to a critical care unit.
The immediate experience varied across visits. In 2022, the patient was seen in fewer than 15 minutes for 40.6% of emergency department visits, according to CDC FastStats: Emergency Department Visits. Overall, 11.5% of visits resulted in hospital admission, while 2.4% resulted in transfer to a different psychiatric or other hospital.
Who uses emergency care
Emergency department use differed by age, sex, living setting, and region. The 2022 CDC NHAMCS tables recorded 3.597 million visits by children under age 1. Infants had a visit rate of 98.9 per 100 people, compared with 65.2 per 100 for children ages 1–4 and 32.1 per 100 for children ages 5–14.
Among older children and adults, the 2022 rates were 47.5 per 100 people for ages 15–24, 45.3 for ages 25–44, and 43.8 for ages 45–64. The rate rose to 58.4 for people ages 65 and older and 76.0 for adults ages 75 and older.
The reported rate was 51.0 visits per 100 people for females and 43.5 for males. These are population-level visit rates, not measures of individual risk or a judgment about the medical seriousness of any one visit.
Living setting showed especially large differences in the 2022 tables. People arriving from private residences had a visit rate of 44.5 per 100 people. Nursing home residents had a rate of 240.9 per 100, while people who were homeless had a rate of 337.1 per 100. These statistics describe emergency department use associated with each population and should not be read as evidence that a single factor causes a visit.
The regional distribution of visits also varied. Emergency departments in the Northeast accounted for 16.2% of visits, the Midwest for 21.6%, the South for 39.8%, and the West for 22.4% in 2022.
| Population or region | 2022 measure |
|---|---|
| Infants under age 1 | 98.9 visits per 100 people |
| Adults age 75 and older | 76.0 visits per 100 people |
| People from private residences | 44.5 visits per 100 people |
| Nursing home residents | 240.9 visits per 100 people |
| People who were homeless | 337.1 visits per 100 people |
| South share of all visits | 39.8% |
Why people visit
Symptoms were prominent among the principal reasons for emergency department visits in the 2022 CDC NHAMCS tables. Stomach and abdominal pain, cramps, and spasms accounted for 8.4% of the listed top principal reasons. Chest pain and related symptoms accounted for 5.4%.
Cough, shortness of breath, and fever each accounted for 3.8% of the top principal reasons. Headache accounted for 2.7%. These percentages identify the share associated with each listed reason; they do not mean that every patient with the symptom had the same diagnosis or outcome.
The diagnosis categories show a related but different view. Diseases of the respiratory system accounted for 8.9% of primary diagnoses in 2022. Diseases of the musculoskeletal system and connective tissue accounted for 7.0%, while diseases of the digestive system accounted for 5.7%.
Diseases of the genitourinary system accounted for 4.7% of primary diagnoses. Pregnancy, childbirth, and the puerperium accounted for 1.7%. A principal reason is the presenting reason recorded for a visit, whereas a primary diagnosis is a diagnostic classification, so the two measures should not be combined as though they were identical categories.
Triage and clinical measurements
Triage records indicate how visits were classified by urgency when patients arrived. In 2022, level 1, immediate, accounted for 1.0% of emergency department visits. Level 2, emergent, accounted for 10.1%, and level 3, urgent, accounted for 33.1%.
Level 4, semiurgent, accounted for 19.4%, while level 5, nonurgent, accounted for 1.8%. No triage was recorded for 8.8% of visits, and triage was unknown or blank for 25.8%. Because more than one-fifth of records were unknown or blank in this measure, the recorded levels should not be treated as a complete classification of every visit.
Age groups showed different recorded triage distributions. Among visits by children under age 15, 22.3% were triaged as level 3, urgent, and 31.6% as level 4, semiurgent. Among adults ages 65 and older, 15.4% were triaged as level 2, emergent, and 40.3% as level 3, urgent. Among adults ages 75 and older, 2.4% were triaged as level 1, immediate.
The tables also report selected measurements at the visit. Febrile temperature was recorded for 3.2% of visits, while normal temperature was recorded for 91.3%. Pulse oximetry was 95%–100% at 85.9% of visits and below 95% at 7.7%. These measurements are recorded clinical findings, not a complete description of each patient’s condition.
What happens after arrival
The expected source of payment varied across emergency department visits in 2022. Medicaid, CHIP, or another state-based program was the expected source for 40.3% of visits. Private insurance was expected for 29.8%, and Medicare for 22.0%.
Dual Medicare and Medicaid coverage was expected for 4.0% of visits. No insurance was expected for 6.2%, and self-pay accounted for 6.0%. Workers’ compensation accounted for 0.7%, no charge or charity care for 0.3%, and other payment sources for 4.2%. The payment source was unknown or blank for 9.2% of visits.
The same 2022 national data recorded the type of visit. Initial visits accounted for 84.0% of emergency department visits, while follow-up visits accounted for 4.9%. The remaining records are not characterized here because the supplied figures do not provide a complete breakdown of all visit types.
Disposition figures help show that emergency departments serve both patients who leave after evaluation and patients who need additional hospital care. CDC FastStats reports that 11.5% of visits resulted in hospital admission, and 3.1 million visits resulted in admission to a critical care unit. The 17.8 million total visits resulting in hospital admission is a count, while 11.5% is a percentage; they are related measures reported by the CDC but should not be treated as interchangeable calculations.
Chronic conditions and medication patterns
The CDC NCHS Report 174 examined adult emergency department visits averaged across 2017–2019, a measurement period distinct from the 2022 national visit totals. Adults made about 107.3 million emergency department visits per year during 2017–2019. At least one selected chronic condition was present in 59.5% of adult visits.
Within that adult analysis, 24.9% of visits involved adults with one chronic condition, 16.5% involved adults with two, and 18.1% involved adults with three or more. The report also states that 40.6% of adult visits were made by adults with none of the selected chronic conditions.
Age differences were pronounced in the chronic-condition measures. Among adults ages 18–44, 70.3% of emergency department visits were made by patients with no chronic conditions, while 48.2% were made by patients with one chronic condition. Among adults ages 75 and older, 3.3% of visits were made by patients with no chronic conditions and 11.2% by patients with one chronic condition.
Expected payment also varied with chronic-condition count. Among adult visits involving one chronic condition, Medicaid was the primary expected source for 31.7%, Medicare for 26.7%, no insurance for 10.6%, and other payment sources for 3.2%. Medicare was the primary expected source for 40.8% of visits involving two chronic conditions and 57.6% of visits involving three or more.
Medication patterns differed as well. One or two medications were given or prescribed in 39.6% of visits involving adults with no chronic conditions and 31.4% involving adults with three or more chronic conditions. Five or more medications were given or prescribed in 15.1% of visits involving adults with no chronic conditions and 28.5% involving adults with three or more.
CDC NCHS Data Brief 461 reports opioid prescribing at discharge for 36.4 emergency department visits per 1,000 adults in 2019–2020, compared with 50.5 per 1,000 in 2017–2018. In 2019–2020, the rate was 39.9 per 1,000 women and 32.6 per 1,000 men. In 2017–2018, it was 56.6 per 1,000 women and 43.9 per 1,000 men.
Injuries among older adults
The CDC MMWR 2021 analysis focused on selected nonfatal injuries among adults ages 65 and older in 2018. It counted 2.4 million associated emergency department visits, corresponding to an injury-related emergency department visit rate of 4,744 per 100,000 adults in that age group.
Unintentional falls accounted for 91.8% of those selected injury-related visits, while unintentional traffic-related motor vehicle crashes accounted for 7.8%. The fall-related emergency department visit rate was 5,003 per 100,000 for women ages 65 and older and 3,530 per 100,000 for men.
Fall-related rates rose with age: 2,678 per 100,000 among adults ages 65–74, 4,900 among ages 75–84, and 9,867 among adults ages 85 and older. Crash-related emergency department visit rates were 401 per 100,000 for ages 65–74, 337 for ages 75–84, and 236 for adults ages 85 and older.
The same 2018 analysis reported unintentional opioid overdose-related emergency department visit rates of 18 per 100,000 among men ages 65 and older and 14 per 100,000 among women. Among adults ages 65–74, the self-harm emergency department visit rate was 13 per 100,000.
Hospitalization rates following injuries also increased with age for falls. The fall-related injury hospitalization rate was 1,494 per 100,000 among women ages 65 and older and 1,035 among men. By age group, the rates were 561 per 100,000 for ages 65–74, 1,504 for ages 75–84, and 3,857 for adults ages 85 and older. For motor vehicle crash injuries, hospitalization rates were 91 per 100,000 among men ages 65 and older and 74 among women.