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. 2015 Jul;34(7):681-5.
doi: 10.1097/INF.0000000000000704.

Infectious Disease-related Emergency Department Visits Among Children in the US

Kohei Hasegawa  1 , Yusuke Tsugawa, Ari Cohen, Carlos A Camargo Jr
Affiliations

Infectious Disease-related Emergency Department Visits Among Children in the US

Kohei Hasegawa et al. Pediatr Infect Dis J. 2015 Jul.

Abstract

Background: Although most research on infectious diseases (IDs) has focused on hospitalizations, this provides an incomplete picture of healthcare utilization. We describe the burden and epidemiologic features of ID-related emergency department (ED) visits among U.S. children.

Methods: We conducted a cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We identified children who presented to the ED with a primary diagnosis of ID. Outcome measures were ID-related ED visits, hospitalizations through the ED and ED charges.

Results: During 2011, we identified 1,914,509 ID-related ED visits among U.S. children, corresponding to a weighted estimate of 8,524,357 ED visits. This accounted for 28% of all ED visits by children. The frequency of ID-related ED visits was 10,290 visits per 100,000 children. The most common diagnoses were upper respiratory infection (41%), otitis media (18%) and lower respiratory infection (14%). Overall, 62% of ID-related ED visits were made by children with Medicaid; 35% were by those in the lowest income quartile. Among the ID-related ED visits, 424,725 (5%) resulted in hospitalization, with 513 hospitalizations per 100,000 children. The most common reason for hospitalization was lower respiratory infection, which accounted for 40% of all ID-related hospitalizations from the ED. Median charge per ED visit was $718, with total annual charges of $9.6 billion.

Conclusions: The public health burden of IDs, as measured by ED visits, subsequent hospitalizations and associated charges, was substantial. We also found that children with markers of lower socioeconomic status comprised a disproportionately high proportion of ID-related ED visits.

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Conflict of interest statement

Conflicts of Interest: All of the authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1
Figure 1
Frequency of Infectious Disease Emergency Department Visits among Children in the United States in 2011, according to Month of Visit
See this image and copyright information in PMC

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