Emergency Department Volume and Capacity by Facility, Health Category and Health Professional Shortage Area
The statewide median number of emergency department visits per treatment station increased 18% between 2021 and 2023. Hospitals located in areas designated as Health Professional Shortage Areas (HPSAs) for both Primary Care and Mental Health experienced a higher median ED burden.
Why Look At Emergency Department Volume and Capacity by Facility?
Emergency Department (ED) burden is an important measure of hospital and health system utilization. The Emergency Department Volume and Capacity by Facility visualization illustrates the ratio between the number of ED visits and the number of ED treatment stations as reported by each hospital on the HCAI Annual Utilization Report. This ratio is a measure of burden on the ED. Smaller ratios indicate fewer ED visits per available treatment station and less burden. Larger ratios of ED visits per available treatment station indicate greater burden.
Filters for specific health-related topics are included in this visualization to allow users to analyze the ED burden ratio by diagnosis and housing status. Patients may be counted in more than one health category if they received multiple diagnoses during the visit. Patients who live in areas with fewer healthcare professionals may use the ED as a primary source of care, including for care that is not urgent. Filters for Health Professional Shortage Area (HPSA) designations allow users to analyze primary care and mental health provider shortages against the demand for ED services and where the ED burden may be relieved by greater provider supply.
What is a HPSA? A Health Professional Shortage Area (HPSA) is a geographic area, population group, or healthcare facility that has been designated by the Health Resources and Services Administration (HRSA) as having a shortage of health professionals. There are three categories of HPSAs: Primary Care, Dental Health, and Mental Health.
Key Findings
- The California statewide median number of ED visits per treatment station increased 18% from 1,270 in 2021 to 1,500 in 2023.
- For individual California hospitals in 2023, the ratio of ED visits to treatment stations ranged from 167 visits per station to 4,714 visits per station. This range continues to get broader every year from 2021 to 2023.
- The health-related topic with the highest statewide median ED burden ratio is hypertension (269 ED visits per station), followed by diabetes (132 ED visits per station) and asthma (50 ED visits per station).
- Substance abuse ranked as the second-highest statewide median ED burden ratio in 2021 and 2022 but dropped to the fourth-highest in 2023.
- Hospitals located in areas designated as HPSAs for both Primary Care and Mental Health experienced a higher median ED burden, with 1,310 visits per station in 2021 and 1,510 visits per station in 2023, respectively.
- In 2023, hospitals in HPSAs for Primary Care have a lower ED burden, with a median ratio of 1,479 ED visits per station, compared to hospitals in HPSAs for Mental Health, which have a median ratio of 1,540 ED visits per station.
- In 2023, hospitals designated as Frontier had a lower median ratio (1,228 ED visits per station) than the state average. In contrast, hospitals designated as Rural had a higher median ratio (1,530 ED visits per station) than the state average, while Urban hospitals had nearly identical ED burden ratios to the state average.
- Teaching hospitals had a significantly lower median ED burden ratio of 1,224 visits per station compared to Non-Teaching hospitals, which had a median ratio of 1,531 visits per station.
Visualization
How HCAI Created This Product
- This product was created using the Hospital Utilization Data and the Hospital Emergency Department Data from 2021 to 2023. Due to variations in reporting methodologies, the two data sources may occasionally yield different figures. To maintain clarity in the visualization, some records may not be included.
- If the hospital is a subsidiary or division of another corporation and the corporation has three or more hospitals, then that corporation name indicates the hospital system.
- An ED treatment station is defined as a specific space within the ED that is adequate to treat one patient at a time. Holding or observation beds are not included.
- The number of encounters is all recorded healthcare encounters for a specific health-related topic. Individual patients may be counted in more than one category if they received multiple diagnoses during a single encounter (e.g., a person who had diabetes and pneumonia would be counted in both the diabetes category and the pneumonia category).
- The definitions for the mental health and substance abuse categories were adopted from the Massachusetts Center for Health Information and Analysis, which consulted with clinicians and the Agency for Healthcare Research and Quality (AHRQ).
- Patients’ ICD-10 diagnosis codes were used to identify the health-related topics categories. For more information about asthma, COPD, diabetes, hypertension, and pneumonia categories please visit the AHRQ Preventable Quality Indicators of California webpage.
- The homeless category was defined for 2023 data by the by the presence of the ICD-10-CM diagnosis code “Z59.0” in any diagnosis position and/or a “Homelessness Indicator”. For 2021 and 2022 data, the homeless category was defined using the ICD-CM code “Z59.0” and/or patient zip code of “ZZZZZ”. For more information about homeless encounters, please visit the Inpatient Hospitalizations and Emergency Department Visits for Persons Experiencing Homelessness in California webpage.
- Active COVID-19 and COVID-19 History were defined by the ICD-10-CM diagnosis codes of “U071”, “B9729”, and “J1282” (Active COVID-19) and “Z8616” and “U099” (COVID-19 History). The COVID-19 History diagnosis codes are used to identify patient encounters where the patient has had a personal history of COVID-19, but is not presenting with COVID-19 during the encounter.
Additional Information
Topic: Healthcare Utilization
Source Link: Hospital Utilization Data, Health Professional Shortage Areas in California, Hospital Emergency Department – Encounters by Facility
Citation: HCAI – Hospital Utilization Data, Health Professional Shortage Areas in California, Hospital Emergency Department – Encounters by Facility, 2021-2023
Temporal Coverage: 2021-2023
Spatial/Geographic Coverage: Statewide, County
Frequency: Annually