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Top 10 Diagnoses for One-Time ED Users and Super-Users in New York City

The reasons for emergency department visits in New York City differ greatly between patients who had one ED visit in a year and those who had frequent ED visits, according to a United Hospital Fund report.

In the report, "Time and Again: Frequent Users of Emergency Department Services in New York City," patients who had five or more ED visits each year from 2006 through 2008 were dubbed "super-users." Of all New York City ED patients in 2008, 2.3 percent were super-users, whereas 74 percent were one-time ED visitors.

Here is a list of the top 10 reasons for ED visits for one-time ED patients and super-users. The percent in parentheses is the data point for the opposite group. For example, 9.2 percent of one-time ED visits were due to symptoms; signs; and ill-defined conditions, whereas 6.4 percent of super-users' visits were due to that cause. Diagnoses in bold are those that are among the top 10 diagnoses for both one-time ED patients and super-users.

Patients with one ED visit

1.    Symptoms; signs; and ill-defined conditions — 9.2 percent (6.4 percent)
2.    Respiratory infections — 7.5 percent (4.2 percent)

3.    Superficial injury; contusion — 5.7 percent (1.8 percent)
4.    Open wounds — 5.6 percent (less than 1 percent)
5.    Sprains and strains — 4.6 percent (1.4 percent)
6.    Other injuries/external causes — 4.2 percent (1.1 percent)
7.    Ear conditions — 3.7 percent (1.8 percent)
8.    Diseases of the heart — 3.3 percent (3.9 percent)
9.    Diseases of the urinary system — 3.1 percent (2.3 percent)

10.    a. Pregnancy-related visits — 3 percent (2.1 percent)
b. Spondylosis; intervertebral disc disorders; other back problems — 3 percent (3.8 percent)


Super-users

1.    Alcohol-related disorders — 12.5 percent (1.6 percent)
2.    Asthma — 10.8 percent (2.3 percent)
3.    Symptoms; signs; and ill-defined conditions 6.4 percent — (9.2 percent)
4.    Psychiatric disorders — 6.3 percent (2 percent)
5.    Respiratory infections — 4.2 percent (7.5 percent)
6.    Diseases of the heart — 3.9 percent (3.3 percent)
7.    Spondylosis; intervertebral disc disorders; other back problems — 3.8 percent (3 percent)
8.    Diseases of the urinary system — 2.3 percent (3.1 percent)
9.    Pregnancy-related visits — 2.1 percent (3 percent)

10.    Substance-related disorders — 2 percent (less than 1 percent)

More Articles on ED Utilization:

5 Characteristics of New York City ED "Super-Users"
Study: Hospitalist Team in ED Reduces Diversion

California Bill Would Limit Hospital Charges on Out-of-Network ED Patients

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