Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse

From the Rural Health Reform Research Center (PDF):

Overall, an estimated 43.4 million adults in the U.S. had any mental illness in 2015; 15.1 million were diagnosed with alcohol abuse.

In 2007, the Agency for Healthcare Research and Quality (AHRQ) reported that 12.5% of all Emergency Department (ED) visits were related to mental health or substance abuse (MH/SA) (based on all-listed diagnoses).

Of those 95 million MH/SA ED visits, 4.1 million had MH/SA as the primary diagnosis.2
While research has identified general utilization and cost of emergency services for MH/SA care, little research specifically addresses rural utilization, and rural populations at greater risk of utilizing the ED for a MH/SA diagnosis.

Utilizing data from the Healthcare Cost and Utilization Project’s (HCUP’s) State  Emergency Department Databases (SEDD) for seven states, researchers explored, and describe in this brief, the use of the ED for MH/SA among Urban, Large Rural, Small Rural, and Isolated Small Rural residents. The proportion of ED visits with a primary MH/SA diagnosis increased nationally. While results indicate that utilization is lower among the more rural U.S. residents, individuals utilizing the ED for MH in rural communities share different characteristics than those in urban areas, which subsequently may impact cost of care, and proposed interventions.

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