NCHS Data Brief ■ No. 367 ■ June 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Emergency Department Visits Among 

Adults Aged 60 and Over: United States, 2014–2017

Jill J. Ashman, Ph.D., Susan M. Schappert, M.A., and Loredana Santo, M.D., M.P.H.

Key findings

Data from the National 

Hospital Ambulatory 

Medical Care Survey

● In 2014–2017, the 

emergency department (ED) 

visit rate for persons aged 60 

and over was 43 visits per 100 

persons aged 60 and over and 

increased with age, from 34 

visits per 100 persons aged 

60–69 to 86 visits per 100 

persons aged 90 and over. 

● About 7% of ED visits 

among patients aged 60 and 

over were made by nursing 

home residents, and this 

percentage increased with age.

● About 30% of patients aged 

60 and over who visited the ED 

arrived by ambulance, and this 

percentage increased with age. 

● The percentage of ED visits 

among patients aged 60 and 

over due to unintentional falls 

increased with age.

● Nearly one-quarter of ED 

visits among patients aged 60 

and over resulted in a hospital 

admission, and this percentage 

increased with age.

In the United States, the number of older adults is increasing. From 2007 to 

2017, the number of adults aged 60 and over increased from 52 million to 

71 million, and during the same time period, the share of the U.S. population 

comprising older adults also increased from 17% to 22% (1,2). During 

2014–2017, 20% of all emergency department (ED) visits in the United States 

were made by patients aged 60 and over, representing an annual average of 

approximately 29 million ED visits (3–6). Given their growing proportion of 

the population, older individuals will make up an increasingly larger share of 

ED visits in the coming years. This report describes ED visits made by adults 

aged 60 and over, assessing selected characteristics by age.

The ED visit rate increased with age for persons aged 60 and 

over.

Figure 1. Emergency department visit rates for patients aged 60 and over, by age: United States, 

2014–2017

NOTES: Based on a sample of 16,497 emergency department (ED) visits made by patients aged 60 and over, representing an 

annual average of approximately 29 million ED visits (20% of all ED visits). Visit rates are based on the July 1, 2014–July 1, 2017, 

sets of estimates of the civilian noninstitutionalized population of the United States, as developed by the U.S. Census Bureau’s 

Population Division. Trend shown is significant (p < 0.05). Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/

databriefs/db367-tables-508.pdf#1.

SOURCE: NCHS, National Hospital Ambulatory Medical Care Survey, 2014–2017. Visits per 100 persons

60 and over 60–69 70–79 80–89 90 and over

100

80

60

40

20

0

43

34

44

67

86

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 367 ■ June 2020

■  2  ■

● In 2014–2017, there were 43 ED visits per 100 persons aged 60 and over (Figure 1).

● The ED visit rate increased with age, from 34 visits per 100 persons aged 60–69 to 86 visits 

per 100 persons aged 90 and over.

The percentage of ED visits made by nursing home residents increased 

with age for patients aged 60 and over.

● In 2014–2017, nursing home residents accounted for 7% of ED visits made by patients aged 

60 and over (Figure 2).

● The percentage of ED visits made by nursing home residents increased with age: 2% of 

visits by patients aged 60–69, 6% of visits by patients aged 70–79, 12% of visits by patients 

aged 80–89, and 24% of visits by patients aged 90 and over.

Figure 2. Emergency department visits made by nursing home residents aged 60 and over, by age: United States, 

2014–2017

NOTES: Based on a sample of 16,497 emergency department (ED) visits made by patients aged 60 and over, representing an annual average of approximately 

29 million ED visits (20% of all ED visits). Trend shown is significant (p < 0.05). Access data table for Figure 2 at: https://www.cdc.gov/nchs/data/databriefs/db367-

tables-508.pdf#2.

SOURCE: NCHS, National Hospital Ambulatory Medical Care Survey, 2014–2017. Percent of ED visits 

30

20

10

0

60 and over 60–69 70–79 80–89 90 and over

7

2

6

12

24
NCHS Data Brief ■ No. 367 ■ June 2020

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The percentage of ED visits made by patients arriving at the hospital in an 

ambulance increased with age for patients aged 60 and over.

● In 2014–2017, patients arriving at the hospital in an ambulance accounted for 30% of ED 

visits made by patients aged 60 and over (Figure 3).

● The percentage of ED visits where patients arrived at the hospital in an ambulance increased 

with age: 23% of visits by patients aged 60–69, 29% of visits by patients aged 70–79, 39% 

of visits by patients aged 80–89, and 53% of visits by patients aged 90 and over.

Figure 3. Arrival by ambulance for emergency department visits made by patients aged 60 and over, by age: 

United States, 2014–2017

NOTES: Based on a sample of 16,497 emergency department (ED) visits made by patients aged 60 and over, representing an annual average of approximately 

29 million ED visits (20% of all ED visits). Trend shown is significant (p < 0.05). Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db367-

tables-508.pdf#3.

SOURCE: NCHS, National Hospital Ambulatory Medical Care Survey, 2014–2017. Percent of ED visits 

60

40

20

0

60 and over 60–69 70–79 80–89 90 and over

30

23

29

39

53
NCHS Data Brief ■ No. 367 ■ June 2020

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The percentage of ED visits caused by an unintentional fall increased with 

age for patients aged 60 and over.

● In 2014–2017, unintentional falls accounted for 13% of ED visits made by patients aged 60 

and over (Figure 4).

● The percentage of ED visits caused by an unintentional fall increased with age: 10% of 

visits by patients aged 60–69, 12% of visits by patients aged 70–79, 17% of visits by 

patients aged 80–89, and 25% of visits by patients aged 90 and over.

Figure 4. Emergency department visits caused by unintentional falls for patients aged 60 and over, by age: United States, 

2014–2017

NOTES: Unintentional falls were defined using the International Classification of Diseases, Ninth Revision, Clinical Modification codes E880–E886 and E888, and 

the International Classification of Diseases, 10th Revision, Clinical Modification codes W00–W19. Based on a sample of 16,497 emergency department (ED) visits. 

for patients aged 60 and over, representing an annual average of approximately 29 million ED visits (20% of all ED visits). Trend shown is significant (p < 0.05). 

Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db367-tables-508.pdf#4.

SOURCE: NCHS, National Hospital Ambulatory Medical Care Survey, 2014–2017. Percent of ED visits 

30

20

10

0

60 and over 60–69 70–79 80–89 90 and over

13

10

12

17

25
NCHS Data Brief ■ No. 367 ■ June 2020

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The percentage of ED visits that resulted in a hospital admission increased 

with age for patients aged 60 and over.

● In 2014–2017, the percentage of ED visits that resulted in hospital admission accounted for 

23% of ED visits made by patients aged 60 and over (Figure 5).

● The percentage of ED visits that resulted in hospital admission increased with age: 19% 

of visits by patients aged 60–69, 23% of visits by patients aged 70–79, 30% of visits by 

patients aged 80–89, and 33% of visits by patients aged 90 and over.

Figure 5. Emergency department visits resulting in a hospital admission for patients aged 60 and over, by age: 

United States, 2014–2017

NOTES: Based on a sample of 16,497 emergency department (ED) visits made by patients aged 60 and over, representing an annual average of approximately 

29 million ED visits (20% of all ED visits). Trend shown is significant (p < 0.05). Access data table for Figure 5 at: https://www.cdc.gov/nchs/data/databriefs/db367-

tables-508.pdf#5.

SOURCE: NCHS, National Hospital Ambulatory Medical Care Survey, 2014–2017. Percent of ED visits 

30

40

20

10

0

60 and over 60–69 70–79 80–89 90 and over

23

19

23

30

33
NCHS Data Brief ■ No. 367 ■ June 2020

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Summary

This report examined ED visits made by older adults in 2014–2017 by age group: 60–69, 

70–79, 80–89, and 90 and over. The ED visit rate increased with age. In addition, several other 

characteristics also increased with age, including the percentage of visits made by nursing home 

residents; the percentage of visits where the patient arrived by ambulance; the percentage of visits 

where the visit was caused by an unintentional fall; and the percentage of visits where the patient 

was admitted to the hospital after the ED visit. As the U.S. population continues to grow older, 

monitoring use and provision of ED services among this population may help inform the ability 

of EDs to handle the unique needs of older patients.

Definitions

Arrival by ambulance: ED visits at which the patient arrived in an ambulance, either by air or 

ground. This includes private and public ambulances that can provide either advanced life support 

or basic life support. 

ED visit rate: Calculated by dividing the number of ED visits by persons aged 60 and over, 

by the July 1, 2014–July 1, 2017, estimates of the civilian noninstitutionalized population 

of the United States (obtained from the U.S. Census Bureau’s Population Division) for each 

demographic group.

Hospital admission: ED visits that resulted in the patient being admitted to the hospital.

Nursing home resident: Refers to the patient’s current place of residence being a nursing home.

Unintentional fall: Any mention of the International Classification of Diseases, Ninth Revision, 

Clinical Modification (7) codes E880–E886 and E888 (2014–2015), and the International 

Classification of Diseases, 10th Revision, Clinical Modification (8) codes W00–W19 

(2016–2017). Up to five diagnoses and three causes of injury were included.

Data source and methods

Data for this report are from the National Hospital Ambulatory Medical Care Survey 

(NHAMCS), an annual nationally representative survey of nonfederal, general, and short-stay 

hospitals. NHAMCS provides data on the use and provision of ambulatory care services in 

hospital emergency departments. Between 2014 and 2017, the weighted NHAMCS response 

rate ranged from 62.8% (2017) to 73.9% (2014). Additional information on the methodology of 

NHAMCS has been previously described (9–12). 

This report presents results combining data for 2014–2017 to enable more detailed subgroup 

analyses. Estimates of the weighted number of visits are based on 4-year annual averages. 

Data analyses were performed using the statistical packages SAS version 9.4 (SAS Institute, 

Cary, N.C.) and SAS-callable SUDAAN version 11.0 (RTI International, Research Triangle 

Park, N.C.). Linear regression was used to test the significance of slopes for all age trends. All 

percentage estimates presented meet NCHS guidelines for presentation of proportions (13) and 

follow National Center for Health Statistics (NCHS) trend analysis guidelines (14). Linear trends 

by age were evaluated using linear regression. The significance level for statistical testing was set 

at p < 0.05.
NCHS Data Brief ■ No. 367 ■ June 2020

■ 7  ■

About the authors

Jill J. Ashman, Susan M. Schappert, and Loredana Santo are with the National Center for Health 

Statistics, Division of Health Care Statistics, Ambulatory and Hospital Care Statistics Branch.

References

1. U.S. Census Bureau. POV–01. Age and sex of all people, family members and unrelated

individuals, 2007 and 2017. Available from: https://www.census.gov/data/tables/time-series/

demo/income-poverty/cps-pov/pov-01.2007.html.

2. Administration for Community living, U.S. Department of Health and Human Services. 2018

profile of older Americans. 2018. Available from: https://acl.gov/sites/default/files/Aging%20

and%20Disability%20in%20America/2018OlderAmericansProfile.pdf.

3. National Center for Health Statistics. 2014 NHAMCS micro-data file. 2017. Available from:

ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHAMCS.

4. National Center for Health Statistics. 2015 NHAMCS micro-data file. 2017. Available from:

ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHAMCS.

5. National Center for Health Statistics. 2016 NHAMCS micro-data file. 2018. Available from:

ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHAMCS.

6. National Center for Health Statistics. 2017 NHAMCS micro-data file. 2019. Available from:

ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHAMCS.

7. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid

Services. International classification of diseases, ninth revision, clinical modification

(ICD–9–CM), Sixth Edition. DHHS Pub No. (PHS) 06–1260. 2011.

8. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention,

Centers for Medicare and Medicaid Services. International classification of diseases, 10th

revision, clinical modification (ICD–10–CM). 2017. Available from: https://www.cdc.gov/nchs/

icd/icd10cm.htm.

9. National Center for Health Statistics. 2014 NHAMCS micro-data file documentation.

2017. Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/

NHAMCS/doc14_ed.pdf.

10. National Center for Health Statistics. 2015 NHAMCS micro-data file documentation.

2017. Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/

NHAMCS/doc15_ed.pdf.

11. National Center for Health Statistics. 2016 NHAMCS micro-data file documentation.

2018. Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/

NHAMCS/doc16_ed.pdf.

12. National Center for Health Statistics. 2017 NHAMCS micro-data file documentation.

2019. Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/

NHAMCS/doc17_ed-508.pdf.
NCHS Data Brief ■ No. 367 ■ June 2020

13. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez JF 

Jr, et al. National Center for Health Statistics data presentation standards for 

proportions. National Center for Health Statistics. Vital Health Stat 2(175). 

2017. 

14. Ingram DD, Malec DJ, Makuc DM, Kruszon-Moran D, Gindi RM, 

Albert M, et al. National Center for Health Statistics guidelines for analysis 

of trends. National Center for Health Statistics. Vital Health Stat 2(179). 

2018.

Keywords: ambulance • emergency care • falls • hospital admission • older 

adults • National Hospital Ambulatory Medical Care Survey

Suggested citation

Ashman JJ, Schappert SM, Santo L. 

Emergency department visits among adults 

aged 60 and over: United States, 2014–2017. 

NCHS Data Brief, no 367. Hyattsville, MD: 

National Center for Health Statistics. 2020.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Jennifer H. Madans, Ph.D., Acting Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health Care Statistics

Denys T. Lau, Ph.D., Director

Alexander Strashny, Ph.D., Associate 

Director for Science

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