A Demographic Overview of Children in the Emergency Department: Findings from the NHAMCS, 2019-2021

Peds in the ED

Authors

  • Allie Rice Oklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Tulsa, Oklahoma
  • Madison Taylor Oklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Tulsa, Oklahoma
  • Micah Hartwell Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, Oklahoma
  • Amy Hendrix-Dicken University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
  • Christine Beeson University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

Abstract

Background

Our primary objective was to analyze and describe the population characteristics —including race and ethnicity, age, insurance status, and comorbidities—among all pediatric ED visits included in the National Hospital Ambulatory Medical Survey (NHAMCS). Due to prevalent healthcare disparities, our secondary objective was to evaluate the demographic factors in triage level, ED wait times, and intentional vs unintentional traumas and poisoning.

Method

We conducted a cross-sectional analysis using the 2021 NHAMCS data to determine the prevalence of pediatric ED visits in the United States. Our sample consisted of 337 hospitals in the US, reporting 16,207 ED visits. We used X2 tests logistic regression to assess wait times, triage level, and self-inflicted injuries or poisoning.

Results  

Our results showed that Indigenous children's wait times were twice that of other racial groups. Additionally, rates of ED visits for trauma, poisoning, or overdose were higher in non-MSA regions. Lastly, children aged 15-17 had the highest percentage of emergent triage level visits—nearly double the percentage for all other age group categories.

Conclusion

In summary, our study represents a pediatric ED population primarily composed of children under 7 years of age, within MSA regions, and consistent with the national ethnoracial census. More than 12% of pediatric ED patients had 1 or more comorbidities, and nearly 3 in 5 visits were covered through Medicaid/CHIP. To improve overall access and decrease non-emergent ED usage, we recommend that healthcare workers implement extended hours, expanded language services, and use of telehealth. 

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Published

2025-05-14

Issue

Vol. 9 No. 1 (2025): Articles

Section

Public Health

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