New Report Studies Emergency Departments Serving High Volumes of “Safety-Net” Patients

For Immediate Release: May 21, 2004

Contact: NCHS/CDC Public Affairs, (301) 458-4800

Characteristics of Emergency Departments Serving High Volumes of Safety-net Patients: United States, 2000. Series Report 13, Number 155. 23 pp. (PHS) 2004-1726 [PDF – 3.7 MB]

An analysis of 2000 data shows that approximately one-third of all U.S. hospital emergency departments serve a disproportionately high number of Medicaid and uninsured patients. These hospitals serve as a safety net in communities whose residents are more likely to be low income, uninsured, or Medicaid recipients, and where there are fewer primary care services available.

The findings, published in a new report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, describe the characteristics of “high safety-net” emergency departments. The study examined hospital, community, and patient factors associated with serving safety-net populations as well as the receipt of public funding.

Some 36 percent of the Nation’s emergency departments are considered high safety-net, defined as those where at least 30 percent of the patients are Medicaid eligible; 30 percent are uninsured; or a total of 40 percent of the patients fall into either category. The majority of the high safety-net emergency departments were in this category, with moderate levels of both uninsured and Medicaid recipients.

The study found that:

Emergency departments (ED) located in the South are more likely to serve high safety-net patients. Southern hospitals represent two-thirds of high-burden EDs. EDs located in areas with higher rates of poverty and unemployment and a lower per capita income see a disproportionately larger volume of high safety-net patients.
High safety-net EDs are more likely to be in areas with fewer primary care physicians than other communities and their patients include more African Americans and children, but fewer seniors.
Although the majority of visits at all EDs are for critical conditions, patients at safety-net hospitals are more likely to be treated for nonurgent conditions, such as toothache or back pain. Patients at high safety-net hospitals are less likely to have injuries, less likely to be admitted to the hospital, and more likely to be seen by a resident or intern under the direction of a staff physician.
Nationally, only 41 percent of high safety-net EDs are in hospitals that receive any Federal assistance for treating a disproportionate share of Medicaid and uninsured patients.
Hospitals located in the South that have a high safety-net burden are the least likely to receive Federal subsidy funds compared with hospitals in other regions of the country.

“Characteristics of emergency departments serving high volumes of safety-net patients: United States, 2000” can be viewed at the NCHS Web site. The Web site also contains additional information about the survey based on records from a representative sample of the nation’s emergency departments.