Emergency Department Volume and Capacity by Facility, Health Category and Health Professional Shortage Area

In 2021, the statewide median number of emergency department (ED) visits per ED treatment station was 1,270. Hospitals located in areas designated as Health Professional Shortage Areas for both Primary Care and Mental Health had a higher median ED burden of 1,310 visits per station.

Why Look At Emergency Department Volume and Capacity by Facility, 2021?

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 2021 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 health care 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 ED burdens could be relieved by greater provider supply.

What is a HPSA? A Health Professional Shortage Area (HPSA) is a geographic area, population group, or health care 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

  • For California hospitals, the ED visits-to-treatment station ratio ranges between 482 visits per station and 3,548 visits per station in 2021. The statewide median is 1,270 visits per station.
  • The health-related topics with the highest statewide median ED burden ratio is Hypertension with 243 ED visits per station, followed by Substance Abuse with 150 ED visits per station, and Diabetes with 125 ED visits per station.
  • Hospitals in HPSA Primary Care Shortage Areas have a lower ED burden (median ratio of 1,129 visits per station) than hospitals in HPSA Mental Health Shortage Areas (median ratio of 1,499 visits per station). Hospitals with both HPSA designations had a median ratio of 1,310 visits per station.
  • Hospitals designated as Frontier or Rural (combined median ratio of 1,270 per station), and hospitals designated as Urban (median ratio of 1,269 visits per station) have nearly identical ED burden ratios.
  • Teaching hospitals had a considerably lower median ED burden ratio of 977 visits per station, when compared to Non-Teaching hospitals, which had a median ratio of 1,306 visits per station.

Emergency Department Volume and Capacity, 2021

How HCAI Created This Product

  • This product was created using the 2021 Hospital Utilization Data and the 2021 Hospital Emergency Department Data.
  • An emergency department treatment station is defined as a specific space within the emergency department adequate to treat one patient at a time. Holding or observation beds are not included.
  • The number of encounters is all recorded health care 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. For more information, please visit: https://www.chiamass.gov/assets/docs/r/pubs/2021/CMSR-Emergency-Department-FY2019-Technical-Appendix.pdf.
  • 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: https://hcai.ca.gov/data-and-reports/healthcare-quality/ahrq-quality-indicators/.
  • The homeless category in Health-Related Topic was defined by the ICD-10-CM diagnosis code of “Z59.0” in any diagnosis position and/or patient zip code of “ZZZZZ”. For more information about homeless encounters, please visit: https://hcai.ca.gov/visualizations/inpatient-hospitalizations-and-emergency-department-visits-for-persons-experiencing-homelessness-in-california-patient-demographics-by-facility/
  • 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 History). The COVID 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
Temporal Coverage: 2021
Spatial/Geographic Coverage: Statewide, County
Frequency: Annual