• Timothy Reeder, Elizabeth Locascio, Jody Tucker, Thomas Czaplijski, Nicholas Benson, and William Meggs.
• Department of Emergency Medicine, The Brody School of Medicine at East Carolina University, Greenville, NC 27858, USA. reedert@mail.ecu.edu
• Am J Emerg Med. 2002 Nov 1; 20 (7): 583-7.

AbstractTo explore factors contributing to increased emergency department (ED) utilization, this retrospective chart review compared ED visits for a 2-week period in both 1992 and 2000 at a rural, tertiary medical center. Total ED visits increased 455 between the periods (% increase = 28.6%), whereas county population increased 18,253 (% increase = 16.1%) (P < 0.005). Average age increased from 35.2 +/- 23.8 years to 40.1 +/- 23.6 years (95% confidence interval, difference of means, 3.34 to 6.45). Patients over 80 years increased by 83%, whereas those over 90 years increased 138%. The admission rate, increased from 21.9% to 25.6% (P < 0.005). Patients with Medicare as primary insurance increased from 17.9% to 23.6% (P < 0.005). Increased age of the population, increased acuity as shown by 4 different measurements, and limited access to primary care physicians all contributed to increased ED demand in this study.Copyright 2002, Elsevier Science (USA). All rights reserved.)

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