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Emergency Room Visits by the Numbers

Anthony Amoroso, MD, is a board-certified emergency physician at US Acute Care Solutions. Working in a level two trauma center that sees up to 60,000 patients a year, Dr. Anthony Amoroso provides care and manages operations at the high acuity emergency room (ER). Every year, US hospitals record 145.6 million ER visits, according to the Centers for Disease Control and Prevention (CDC). Of these, 42.2 million are injury-related, 12.6 million require hospital admission, and 2.2 million require admission in the critical care unit. An analysis of over 367,000 ER records collected by the National Electronic Injury Surveillance System in 2014 identified lacerations as the leading cause of ER visits. Other leading causes were muscle sprains and strains, bone fractures, and contusions (bruises). Other common causes were concussions, aspirated-object injuries, burns, dislocations, and electric shocks. Looking at the data closely, sprains were very common among younger people but fell off sharply starting at age 40. However, fractures became more common after age 40 and were the leading cause of ER visits for people aged 70 and above. Men occupied the largest share of ER visits among people younger than 50, but from there women formed the majority of ER patients.

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Highlandville, IA | August 2017

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When Are Patients Admitted to the Hospital from the Emergency Room?

A board-certified emergency medicine physician in Texas, Anthony Amoroso, MD, has been working in the field for upwards of 15 years. The owner of Brazos Valley Charting, Dr. Anthony Amoroso divides his time between running his real-time chart transcription service and managing emergency patient care and admissions at a Level II trauma center as a physician for U.S. Acute Care Solutions. Specialists, primary care physicians, or emergency department physicians are responsible for deciding whether a patient needs hospitalization to restore and improve his or her health after visiting an emergency room. When patients are admitted, the goal is to have their hospital stay last for as short a time as possible before they are discharged to another health care setting or their home. The primary reason people are admitted to the hospital, with the exception of childbirth and pregnancy-related reasons, is due to circulatory disorders. This includes diseases of the blood vessels and heart and accounts for more than 26 percent of all hospital admissions through the emergency department. Following these are respiratory and digestive disorders, respectively comprising roughly 15 and 14 percent of admissions through the emergency department in the United States. Finally, injuries make up 11.4 percent of hospital admissions, followed by mental health and substance abuse, genitourinary, and endocrine disorders. Since many of these conditions are life-threatening, admission from the emergency room is appropriate. However, many physicians admit patients without life-threatening disorders, thus costing hospitals roughly $5 billion extra annually. This discrepancy varies widely between hospitals and physicians, particularly when patients do not have a clear life-threatening condition, such as acute kidney failure or a heart attack. Patients are more than six times as likely to be admitted at facilities that have a high admission rate. Admission risk was also higher among patients who had a urinary tract infection, chronic bronchitis or emphysema, soft tissue infection, or asthma flare-up.

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Becoming More Detail-Oriented

Texas-based physician Dr. Anthony Amoroso graduated from the University of Texas Southwestern Medical Center in Dallas and now practices emergency medicine. In addition, Dr. Anthony Amoroso is the owner of Brazos Valley Charting, a company that provides medical charting for emergency physicians. To become more detail-oriented, a skill that is essential for emergency physicians, you must become organized in your daily work. However, not every form of organization works for every person. For example, some people may choose a color-coded system, while others may prefer creating to-do lists. Regardless of what works best for you, make sure you use your organization system regularly. In addition, you must get into the habit of keeping detailed records. As you go through your day, summarize everything you do, including meetings and appointments. At the end of the day, review all of these activities to make sure you stayed on task. Further, make notes for the next day to help you decide what you need to follow up on or start. While you do all this, make sure the records you keep are accurate and consistent. Keep your bullet-point format the same as you take notes. Follow the same rules of capitalization throughout each document. Use the same metric for each measurement. Doing these things may seem unimportant, but this consistency trains your brain to recognize small details and makes it easier for your colleagues to read and understand your notes.