This HCUP Statistical Brief extends AHRQ’s earlier work on super-utilizers by shifting focus from hospital inpatient stays to emergency department (ED) visits. In this Statistical Brief, we limited our analysis to ED visits among patients who were treated in the ED and then released from the ED, transferred to another type of nonhospital health facility, or died in the ED. Patients who were treated in the ED and then admitted to the same or a different hospital for inpatient services were not included, because they represent a different type of patient (e.g., in terms of condition severity or treatment needs). The earlier HCUP Statistical Briefs that focused on inpatient stays included admitted patients who were initially treated in the ED.
For this report, ED super-utilizers were defined on the basis of a consistent cut-off rule of approximately 2 standard deviations above the mean number of ED visits during 2014, applied to the statistical distribution specific to each payer and age group:
- Medicare aged 65+ years: four or more ED visits per year
- Medicare aged 1-64 years: six or more ED visits per year
- Private insurance aged 1-64 years: four or more ED visits per year
- Medicaid aged 1-64 years: six or more ED visits per year
This Statistical Brief presents pooled 2014 ED data across 13 geographically dispersed States, representing approximately 28 percent of the U.S. population. Patient demographics, resource use, and outcomes of ED visits for super-utilizers are compared with visits for other patients by primary expected payer (Medicare, private insurance, and Medicaid). The five most common first-listed diagnoses for ED visits are also identified for these super-utilizers. Differences greater than 20 percent between estimates are noted in the text.
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