California hospital ERs more likely to treat patients for medical conditions than injuries, study shows

California hospital emergency departments are providing increasing amounts of non-injury care, according to a study published in Health Affairs.

The study found that the rate of emergency department use in California for medical conditions rose 13.4 percent from 2005 to 2011, while the rate of emergency department use for injuries decreased by 0.7 percent. Researchers also found a rise in symptom-related diagnoses, such as abdominal pain, along with nervous system disorders, gastrointestinal disease and mental illness.

The authors, who analyzed data that all non-federal California hospitals report to the Office of Statewide Health Planning and Development, said the trends point out the increasing importance of emergency departments in providing care for complex medical cases, along with the changing nature of illness in the population needing immediate medical attention.

"California EDs are providing increasing amounts of care for complex emergencies related to chronic conditions, infections, and even nonspecific symptoms," the authors wrote. "This trend reflects both changes in the population disease burden and the ED's more central role in healthcare compared to its original charge to treat injured patients and provide charity care."

The rate of emergency department visits for injuries decreased among the uninsured and rose more slowly than non-injury diagnoses among Medicaid beneficiaries and the privately insured. However, Medicare beneficiaries were the only group that exhibited similar percentages of growth for injury and non-injury diagnoses, according to the study. Researchers also found that the rate of emergency department use for mental illness rose faster than any other diagnosis group among patients who were uninsured, and that mental illness was in the five fastest-growing diagnoses among patients with Medicare or private insurance.