Characteristics of Frequent Users of Emergency Departments

It is commonly believed that those who frequent emergency departments (ED) do so inappropriately and contribute substantially to ED overcrowding. These frequent users are presumed to be largely uninsured without a primary care provider. However, findings from this study contradict these common misconceptions. Using the nationally-representative, 2000-2001 Community Tracking Study Household Survey to examine adult ED use, researchers described the frequency of visits among adults who report ED visits and characterized frequent users:

  • 45.2 million adults made one or more ED visits
  • Frequent users (those with four or more visits) made up only 8 percent and accounted for 28 percent of ED visits. The vast majority (92 percent) of adult emergency patients made one to three visits
  • 81 percent of frequent users had a usual source of care and 84 percent had some form of health insurance. Adults who lacked a usual source of care were actually less likely to be frequent users
  • Poverty, poor mental health, poor physical health and having five or more outpatient visits were independently associated with the likelihood of frequent ED use. Medicaid enrollees and Medicare enrollees were also more likely to report frequent use of emergency departments.