Series 13

No. 131

Injury Visits to Hospital

Emergency Departments:

United States, 1992–95

January 1998

Vital and

Health Statistics

From the CENTERS FOR DISEASE CONTROL AND PREVENTION / National Center for Health Statistics

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
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appreciated.

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endorsement by the Public Health Service, U.S. Department of Health and

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Suggested citation

Burt CW, Fingerhut LA. Injury visits to hospital emergency departments:

United States, 1992–95. National Center for Health Statistics. Vital Health

Stat 13(131). 1998.

Library of Congress Catalog Card Number

Burt, Catharine W.

Injury visits to hospital emergency departments: United States, 1992–95.

p. cm. — (Vital and health statistics. Series 13, Data from the National

Health Care Survey ; no. 131) (DHHS publication ; no. (PHS) 98-1792)

‘‘January 1998.’’

By Catharine W. Burt and Lois A. Fingerhut

Includes bibliographical references.

ISBN 0-8406-0536-6

1. Wounds and injuries—United States—Statistics. 2. Hospitals—

Emergency service—Utilization—United States—Statistics. I. Fingerhut, Lois A.

II. National Center for Health Statistics (U.S.) III. Title. IV. Series. V. Series:

DHHS publication ; no. (PHS) 98-1972.

[DNLM: 1. Emergency Service, Hospital—utilization—United States. 2.

Wounds and Injuries— United States—statistics. 3. Ambulatory Care—

United States—statistics. W2 A N148vm no. 131 1998]

RA407.3.A349 no. 131

[RD93.8]

362.1'0973'021 s—dc21

[617.1'00973'021]

DNLM/DLC

for library of Congress 97-42729

CIP

For sale by the U.S. Government Printing Office

Superintendent of Documents

Mail Stop: SSOP

Washington, DC 20402-9328

Printed on acid-free paper.
Injury Visits to Hospital

Emergency Departments:

United States, 1992–95

Series 13:

Data from the National Health Care Survey

No. 131

Hyattsville, Maryland

January 1998

DHHS Publication No. (PHS) 98-1792

Vital and

Health Statistics

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jack R. Anderson, Deputy Director

Jack R. Anderson, Acting Associate Director for

International Statistics

Lester R. Curtin, Ph.D., Acting Associate Director for

Research and Methodology

Jacob J. Feldman, Ph.D., Associate Director for Analysis,

Epidemiology, and Health Promotion

Gail F. Fisher, Ph.D., Associate Director for Data Standards,

Program Development, and Extramural Programs

Edward L. Hunter, Associate Director for Planning, Budget,

and Legislation

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

Vital and Health Statistics Systems

Stephen E. Nieberding, Associate Director for

Management

Charles J. Rothwell, Associate Director for Data

Processing and Services

Division of Health Care Statistics

W. Edward Bacon, Ph.D., Director

Thomas McLemore, Deputy Director

Catharine W. Burt, Ed.D., Chief, Ambulatory Care

Statistics Branch

Malcolm C. Graham, Acting Chief, Technical

Services Branch

Office of Analysis, Epidemiology, and Health Promotion

Lois A. Fingerhut, Special Assistant for Injury Epidemiology
Contents

Abstract ............................................................................................... 1

Introduction ............................................................................................ 1

Data Highlights ......................................................................................... 1

Methods................................................................................................ 2

Results ................................................................................................ 3

Patient Characteristics ................................................................................. 3

Hospital Characteristics ................................................................................ 4

Visit Characteristics ................................................................................... 4

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Appendix I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Source of Data and Sample Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Appendix II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Definition of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

External Cause of Injury Category Descriptions for Mechanism Regardless of Intent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Appendix III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Survey Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Figures

1. Annual rate of injury-related visits to hospital emergency departments by patient’s age, race, and sex: United States,

1992–95 ........................................................................................... 4

2. Annual utilization rate for injuries to hospital emergency departments by geographic region and metropolitan status of

hospital: United States, 1992–95 ....................................................................... 4

3. Percent distribution of leading causes of injury in emergency department visits: United States, 1992–95 ............ 5

4. Emergency department visit rates for injury resulting from falls by age, race, and sex: United States, 1992–95 ....... 6

5. Emergency department visit rates for injury resulting from being struck by or against an object or person by age, race,

and sex: United States, 1992–95 ....................................................................... 6

6. Emergency department visit rates for motor vehicle traffic-related injuries by age, race, and sex: United States,

1992–95 .......................................................................................... 7

7. Emergency department visit rates for injury resulting from cutting or piercing instruments by age, race, and sex:

United States, 1992–95 .............................................................................. 7

8. Percent distribution of emergency department injury visits by mechanism that caused the injury for each age group:

United States, 1992–95 .............................................................................. 8

9. Annual rate of emergency department visits for intentional injuries by patient’s race, sex, and age: United States,

1992–95 .......................................................................................... 9

10. Percent distribution of emergency department visits by principal diagnosis: United States, 1992–95 ................ 9

11. Emergency department visit rates for open wounds by age, race, and sex: United States, 1992–95 . . . . . . . . . . . . . . . . 10

12. Emergency department visit rates for superficial injuries by age, race, and sex: United States, 1992–95 . . . . . . . . . . . . 10

13. Emergency department visit rates for sprains and strains by age, race, and sex: United States, 1992–95 . . . . . . . . . . . . 11

iii
14. Emergency department visit rates for fractures by age, race, and sex: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . 11

15. Percent distribution of emergency department injury visits by principal diagnosis for each age group: United States,

1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

16. Percent distribution of emergency department injury visits by principal diagnosis for selected mechanisms that

caused the injury: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

17. Percent of emergency department injury visits resulting in hospitalization for each age group: United States,

1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

18. Percent of emergency department injury visits resulting in hospitalization for selected mechanisms that caused the

injury: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

19. Rate of drug mention by leading therapeutic class in emergency department injury visits: United States, 1992–95 . . . 15

20. Percent distribution of injury visits to hospital emergency departments by primary expected source of payment:

United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Detailed Tables

Patient and Hospital Characteristics

1. Annual number, percent distribution, and rate of injury-related emergency department visits by patient characteristics,

averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2. Annual number, percent distribution, and rate of injury-related emergency department visits by patient age, race, and

sex, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

3. Annual number and percent of emergency department visits that are for injuries, averaged over a 4-year period:

United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

4. Annual number and percent distribution of injury-related emergency department visits by patient characteristics,

according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . 20

Cause of Injury

5. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the

injury, according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . 22

6. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the

injury, according to patient sex and age, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . 23

7. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the

injury, according to patient race and age, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . 24

8. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the

injury, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . 25

9. Annual number, percent distribution, and rate of emergency department injury visits by intent, according to patient

age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

10. Annual number, percent distribution, and rate of emergency department injury visits by intent, according to hospital

characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

11. Annual number of visits, percent distribution, and rate of emergency department injury visits by intent and mechanism

of external cause, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

12. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent

external causes of injury, according to patient’s age, sex, and race, averaged over a 4-year period: United States,

1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

13. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent

external causes of injury, according to hospital characteristics, averaged over a 4-year period: United States,

1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Principal Diagnosis

14. Annual number and percent distribution of emergency department injury visits by principal diagnosis, according to

patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

15. Annual rate of emergency department injury visits by principal diagnosis, according to patient age, sex, and race,

averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

16. Annual number and percent distribution of emergency department injury visits by principal diagnosis, according to

patient sex and age, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

iv
17. Annual rate of emergency department injury visits by principal diagnosis, according to patient sex and age, averaged

over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

18. Annual number and percent distribution of emergency department injury visits by principal diagnosis, according to

patient race and age, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

19. Annual rate of emergency department injury visits by principal diagnosis, according to patient race and age,

averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

20. Annual number and percent distribution of emergency department injury visits by principal diagnosis, according to

hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

21. Annual rate of emergency department injury visits by principal diagnosis, according to hospital characteristics,

averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

22. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent

principal diagnoses, according to patient’s age, sex, and race, averaged over a 4-year period: United States,

1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

23. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent

principal diagnoses, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . 44

24. Annual number and percent distribution for emergency department injury visits by principal diagnosis for selected

causes of injury, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Visit Disposition

25. Annual number and percent of emergency department injury visits by disposition, according to patient age, sex, and

race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

26. Annual number and percent of emergency department injury visits by disposition, according to hospital characteristics,

averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

27. Annual number, percent distribution, and rate of injury-related emergency department visits that ended in admission to

inpatient status by patient characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . 48

28. Annual number, percent distribution, and rate of injury-related emergency department visits that ended in admission to

inpatient status by hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . 49

29. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the

injury ending in admission to inpatient status, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . 49

30. Annual number and percent distribution of emergency department injury visits by principal diagnosis ending in

admission to inpatient status, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Other Visit Characteristics

31. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent

principal reasons for visit, according to patient’s age, sex, and race: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . 51

32. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent

principal reasons for visit, according to hospital characteristics: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . 52

33. Annual number and percent of emergency department injury visits by selected diagnostic services ordered or

provided, according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . 53

34. Annual number and percent of emergency department injury visits by selected diagnostic services ordered or

provided, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . 54

35. Annual number and percent of emergency department injury visits by selected therapeutic procedures provided,

according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . 55

36. Annual number and percent of emergency department injury visits by selected therapeutic procedures provided,

according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . 56

37. Annual number and percent distribution of medications provided or prescribed in emergency department injury

visits, according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . 57

38. Annual number and percent distribution of medications provided or prescribed in emergency department injury

visits, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . 57

39. Annual number, percent distribution, and rate of drug mentions at emergency department injury visits by therapeutic

class, according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . 58

40. Annual number, percent distribution, and rate of drug mentions at emergency department injury visits by therapeutic

class, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . 59

41. Annual number and percent distribution of medications by the 20 drug entry names most frequently recorded at

emergency department injury visits, according to patient’s age, sex, and race, averaged over a 4-year period:

United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

v
42. Annual number and percent distribution of medications by the 20 drug entry names most frequently recorded at

emergency department injury visits, according to hospital characteristics, averaged over a 4-year period:

United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

43. Annual number and percent of emergency department injury visits by providers seen, according to patient age, sex,

and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

44. Annual number and percent of emergency department injury visits by providers seen, according to hospital

characteristics, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

45. Annual number and percent of emergency department injury visits by expected source of payment, according to

patient age, sex, and race, averaged over a 4-year period: United States, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

46. Annual number and percent of emergency department injury visits by expected source of payment, according to

geographic region, metropolitan status, and hospital ownership, averaged over a 4-year period: United States,

1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Appendix Tables

I. Number of participating hospitals with emergency department injury visits: National Hospital Ambulatory Medical

Care Survey, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

II. Coefficients appropriate for determining approximate relative standard error by type of estimate for hospital

emergency department injury visits, averaged over a 4-year period: National Hospital Ambulatory Medical Care

Survey, 1992–95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

III. Reclassification of principal diagnosis codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

IV. Proposed matrix for external cause of injury mortality and morbidity data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

V. U.S. population estimates used in computing annual visit rates by sex, age, region, and metropolitan status,

averaged over a 4-year period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

VI. U.S. population estimates used in computing annual visit rates by race, sex, and age, averaged over a 4-year

period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

vi
Objectives

This report describes ambulatory

care visits for injuries to hospital

emergency departments in the United

States. Statistics are presented on

selected patient, hospital, and visit

characteristics.

Methods

The data presented in this report

were collected in the National Hospital

Ambulatory Medical Care Survey

(NHAMCS) over a period of 4 years

from 1992 through 1995. The NHAMCS

is a national probability survey of visits

to hospital emergency and outpatient

departments of non-Federal, short-stay,

and general hospitals in the United

States. Sample data were combined

across years and weighted to produce

annual estimates.

Results

From 1992 through 1995, an

estimated 147 million visits for injuries

were made to hospital emergency

departments in the United States, an

average of 36.8 million visits per year

with an annual utilization rate of 14.3

visits per 100 persons. Persons 15–24

years had a higher rate of injury-related

emergency department visits compared

with other age groups. The injury visit

rate was higher in the Midwest than in

the South or West. Injury visits

represented 37.8 percent of all visits to

hospital emergency departments but

53.5 percent of all visits for children

between 5 and 14 years and

48.5 percent of all visits for persons

15–24 years. Open wounds accounted

for the largest proportion of injuries

(22.0 percent). The leading external

causes of injuries included falls, being

struck by or striking against a person or

object, and motor vehicle traffic injuries.

For all ages, 6.3 percent of the injury

visits had a disposition of admission for

inpatient care, while almost one-quarter

of injury visits by persons 65 years and

over resulted in hospitalization. ED

visits caused by poisonings or firearm

injuries were more likely to result in

hospitalization compared with other

causes.

Keywords: emergency department

visits c diagnoses c injury c ICD–9–CM

Injury Visits to Hospital

Emergency Departments:

United States, 1992–95

Catharine W. Burt, Ed.D., Division of Health Care Statistics, and

Lois A. Fingerhut, M.A., Offıce of Analysis, Epidemiology and Health

Promotion

Introduction

A mbulatory medical care, which

occurs in a wide range of

settings, is the predominant

method of providing health care services

for injuries (1). The largest proportion

of the ambulatory care for injuries

occurs in physicians’ offices, but 3 out

of 10 injury visits occur in hospital

emergency departments (ED’s) (2).

Injury visits presenting to hospital ED’s

are usually more serious than those

presenting at physician offices and often

represent the initial contact to a medical

provider for the injury. While data on

ambulatory care visits with injury

diagnoses to physician offices have been

collected since 1973 through the

National Ambulatory Medical Care

Survey (NAMCS), injury visits to

hospital emergency and outpatient

departments have only been collected

since 1992. The emergency department

was selected as the focus of this injury

report primarily because it is the only

ambulatory care data set of the three

(the other two being the physician’s

office and the outpatient department)

that has included external cause of the

injury information since 1992. The other

two added an external cause item

beginning in 1995. Documenting the

external cause of injury is critical for

injury control and prevention activities

(1,3). A previous report provided

summary statistics on injury visits in

hospital emergency departments (4).

This report presents national

average annual estimates of visits to

hospital emergency departments for

injuries, using data for 1992–95,

focusing on patient, hospital, and visit

characteristics of the injury. Patient

characteristics include age, sex, and

race; hospital characteristics include

geographic region, metropolitan status,

and ownership; and visit characteristics

include principal diagnosis, external

cause of injury, visit disposition, reason

for visit, diagnostic and screening

services, procedures, medications,

providers seen, and expected source of

payment.

Data Highlights

+ Nearly 4 out of every 10 visits to

hospital emergency departments in

the United States were for injuries.

Among children 5–14 years,

54 percent of visits were for an

injury, and among males 15–24

years, 65 percent of visits were for

an injury.

+ There was an average of 36.8

million injury visits per year to

hospital emergency departments, an

annual rate of 14.3 visits per 100

persons.

+ Injury visit rates were higher for

males than females and for black

persons compared with white

persons.

+ Injury visit rates in the Midwest

were higher than in the South or

West geographic regions.

+ Private insurance was the expected

source of payment for 34.6 percent

of injury visits. For persons 65 years

Page 1
and over, Medicare was listed for 7

out of 10 injury visits as the

expected source of payment.

+ Falls were the leading external cause

of injury for 24 percent of the ED

injury visits; being struck by or

striking against an object or person

caused another 13 percent; and

motor vehicle traffic incidents

caused the injuries for 12 percent of

the visits for which an external

cause was provided.

+ Visits related to falls were more

common among children under 5

years and the elderly than for other

ages, while visit rates related to

motor vehicle traffic injuries were

higher for persons 15–24 years than

for other ages. Visits for poisoning

were more likely among young

children than older persons.

+ There was an average of 1.9 million

emergency department visits for

intentional injuries, an annual rate of

7.5 visits per 1,000 persons.

+ Among persons 25–44 years old, the

visit rate for intentional injuries for

black males was more than four

times the rate for white males (41.1

and 10.1 visits per 1,000 persons,

respectively).

+ Intentional injury visit rates were

60 percent higher in metropolitan

than nonmetropolitan areas.

+ Open wounds were the leading

diagnosis for injury visits, occurring

at 22 percent of the injury visits.

Males at all age groups were more

likely than females to make visits

with a diagnosis of open wounds.

+ One out of five injury visits to the

emergency department had a

noninjury principal diagnosis such

as back pain.

+ Therapeutic procedures included

wound care (29.6 percent),

orthopedic care (20.2 percent), and

administration of intravenous fluids

(7.2 percent).

+ Medications were prescribed at 7

out of 10 injury visits. The leading

therapeutic class was drugs for the

relief of pain, occurring at almost

one-half of the injury visits.

Antimicrobials were prescribed at

14 percent of the visits.

Immunologic agents, such as tetanus

vaccines, were used at 10 percent of

the visits.

+ Overall, 6 percent of injury visits

resulted in hospitalization; with

persons 65 years and over more

likely than younger persons to be

hospitalized from the emergency

department. Regardless of age, visits

for injuries caused by firearms and

poisoning were more likely to result

in hospitalization compared with

injuries from other causes.

Methods

The data presented in this report

are from the National Hospital

Ambulatory Medical Care Survey

(NHAMCS), a national probability

sample survey conducted by the

Division of Health Care Statistics of the

National Center for Health Statistics,

Centers for Disease Control and

Prevention. The survey years of 1992,

1993, 1994, and 1995 were combined to

provide more reliable estimates for

injury visits than would be found in one

year’s data alone. For example, the

relative standard error of injury visit

rates for black persons 65 years and

over for individual data years was about

20 percent, while the relative standard

error for the 1992–95 average annual

rate was 9 percent. The general effect of

combining 4 years of data is to reduce

by half the size of the confidence

interval around all of the annual average

estimates. Injury visit rates from 1992

through 1995 did not change; thus

combining the 4 years does not mask

any trends.

The target universe of the

NHAMCS includes in-person visits

made in the United States to emergency

departments of non-Federal, short-stay

hospitals (hospitals with an average stay

of less than 30 days) or those whose

specialty is general (medical or surgical)

or children’s general care. The sampling

frame consisted of hospitals that were

listed in the April 1991 SMG Hospital

Database.

A four-stage probability sample

design is used in the NHAMCS (5). The

design involves samples of primary

sampling units (PSU’s), hospitals within

PSU’s, ED’s within hospitals and/or

clinics within outpatient departments,

and patient visits within ED’s and/or

clinics. The PSU sample consists of 112

PSU’s that comprise a probability

subsample of the PSU’s used in the

1985–94 National Health Interview

Survey. The hospital sample for the

NHAMCS includes 600 hospitals that

are divided into 16 panels. In any one

year only 13 panels are used for data

collection. During this period, roughly

94 percent of the in-scope hospitals

participated. In hospitals with an

operating emergency department,

hospital staff were asked to complete

Patient Record forms (see Appendix III

for copies of the forms used in

1992–95) for a systematic random

sample of patient visits occurring during

a randomly assigned 4-week reporting

period. Over the 4-year period, there

was an unweighted total of 113,821

emergency department patient records.

Because the estimates presented in

this report are based on a sample rather

than on the entire universe of ED visits,

they are subject to sampling variability.

Estimates of sampling error were made

using a Taylor Series approximation as

computed by SUDAAN software (6),

which takes the complex sampling

design into account. Appendix I includes

an explanation of sampling errors with

guidelines for judging the precision of

the estimates and documentation on how

statistically significant differences were

determined.

Several medical classification

systems were used to code data from the

NHAMCS. The Patient Record form

contained an item on the patient’s

expressed reason for the visit. In this

item, hospital staff were asked to record,

based on the information found on the

patient’s ED record, the patient’s

‘‘complaint(s), symptom(s), or other

reason(s) for this visit in the patient’s

(or patient surrogate’s) own words.’’ Up

to three reasons for visit were classified

and coded for each record according to

A Reason for Visit Classification for

Ambulatory Care (RVC) (7).

Injury-related complaints are coded in

the following ranges: 5001–5830, 5838,

5900–5925.

Page 2 [ Series 13, No. 131
The Patient Record form also

contained a checkbox item on whether

the visit was injury related and an item

on the external cause of injury for

injury-related visits. Up to three external

causes of injury were classified and

coded according to the ‘‘Supplementary

Classification of External Causes of

Injury and Poisoning,’’ known as

E–codes, found in the International

Classification of Diseases, 9th Revision,

Clinical Modification (ICD–9–CM)(8).

E–codes provide information on both

the intent and mechanism of the injury.

The presentation of external cause of

injury data in this report is based on the

matrix of cause (or mechanism) by

intent (or manner) of injury as described

elsewhere (1,9). In this report, E–codes

for injury include E800–E869,

E880–E929, and E950–E999; adverse

effects of medical treatment

(ICD–9–CM codes E870–E879 and

E930–E949) are excluded from the

injury definition (9). See Appendix II for

definitions of mechanism categories.

In addition, the form contained an

item on diagnosis. The hospital staff was

asked to record the principal diagnosis

or problem associated with the patient’s

most important reason for the current

visit as well as any other significant

current diagnoses found on the ED

record. Up to three diagnoses were

classified and coded according to the

ICD–9–CM. Most injury diagnoses are

in the ICD–9–CM code range 800–999.

Note that there is not necessarily a

direct relationship between the

first-listed external cause of injury and

the principal diagnosis, although in most

cases the two appear to be related. It is

possible that the first-listed external

cause of injury corresponds to the

second- or third-listed diagnosis.

In the medication item, hospital

staff were instructed to record all new or

continued medications ordered, supplied,

or administered at the visit, including

prescription and nonprescription

preparations, immunization and

desensitizing agents, and anesthetics.

For 1992–94, up to five medications,

referred to in this survey as drug

mentions, were coded per visit

according to a classification system

developed at the National Center for

Health Statistics. For 1995, up to six

medications could be coded but for the

purposes of this report, only the first

five were used for consistency. As used

in the NHAMCS, the term ‘‘drug’’ is

interchangeable with the term

‘‘medication,’’ and the term

‘‘prescribing’’ is used broadly to mean

ordering, administering, or providing. A

report describing the method and

instruments used to collect and process

drug information is available (10).

Therapeutic classification of the drugs

mentioned on the Patient Record forms

was determined using the National Drug

Code Directory, 1985 edition (11).

The expected source of payment

item underwent substantial revision for

the 1995 NHAMCS compared with the

previous 3 years, so for the purposes of

this report, the source of payment data

from all 4 years was recoded to a

measure that allowed only one source to

take precedence. Because multiple

entries were allowed for some years, a

hierarchy of categories was developed

as follows: Medicaid, Medicare, health

maintenance organization (HMO) or

other prepaid insurance, private

insurance, self-pay, and other or

unknown.

The U.S. Bureau of the Census,

Housing Surveys Branch, was

responsible for the survey’s data

collection. Data processing operations

and medical coding were performed by

Analytical Sciences Inc., Durham, North

Carolina. As part of the quality

assurance procedure, a 10 percent

quality control sample of survey records

was independently processed. Coding

error rates ranged between 0.1 and

1.9 percent for various survey items.

Several of the tables in this report

present data on rates of emergency

department injury visits. The population

figures used in calculating these rates

are U.S. Bureau of the Census estimates

of the civilian, noninstitutionalized

population of the United States averaged

over the 4-year period, July 1, 1992–95,

and have been adjusted for net

underenumeration. The population

figures are found in Appendix I of this

report. Age-adjusted rates were

calculated when comparing visit rates

between subpopulations. However, since

adjusting for differences in the age

distribution between comparison groups

did not affect the conclusions,

age-adjusted rates are not presented in

this report.

Injury visits were defined

consistently across all 4 years as visits

meeting at least one of the following

criteria as indicated on the Patient

Record form: An indication that the visit

was related to an injury or poisoning

from a checkbox item, the presence of

an external cause of injury, the presence

of an injury diagnosis, or any reason for

visit that indicated an injury. Using any

one of these items alone would

underestimate the number of

injury-related visits as each of these

items measures a unique aspect of

injury. There were a total of 44,897

records from 515 hospitals that indicated

that the visit was related to an injury or

poisoning. From these, national

estimates were produced describing the

characteristics of these visits and the

patients who made them.

Results

There were an estimated 147

million injury visits made to

hospital emergency departments

from 1992 through 1995, an average of

36.8 million visits annually, at a rate of

14.3 visits per 100 persons per year. The

average annual rate was not significantly

different from rates found in each year.

Injury visits accounted for 37.8 percent

of all visits made to emergency

departments for the period 1992–95

(table 1). Patient, hospital, and visit

characteristics for these ED injury visits

are described in the following text.

Patient Characteristics

Injury visit rates were higher for

persons 15–24 years (21.0 visits per 100

persons) than for younger or older

persons; rates were also higher for

children under 15 years of age than for

persons 45 years and over. Injury visit

rates for males were higher than for

females in each age group under 45

years. On the other hand, for persons 65

years and over, the visit rate for females

was 1.3 times that for males.

Series 13, No. 131 [ Page 3
The age-adjusted injury visit rate

for black persons was 1.3 times the rate

for white persons. For persons 15–24

years, injury visit rates for white and

black males were similar (26 and 31 per

100 persons, respectively) and were

about 1.5 to 1.7 times the respective

rates for white and black females.

There were, however, race-sex

differences by age. For young children

under 5 years, the visit rate for white

females was about 0.7 to 0.8 times the

rates for the three other race-sex groups,

while at ages 5–14 years, rates for white

and black males were 1.4 to 1.5 times

the respective rates for white and black

females. For persons 25–44 years, the

injury visit rate for black males (26.7

per 100 persons) exceeded the rates for

the other groups; it was about 1.4 times

the rates for white males and black

females and 2.3 times the rate for white

females. At ages 45–64 years, the visit

rate for black males was 1.3 to 1.8

times the rates for the three other

race-sex groups, and for those 65 years

and over, the injury visit rate for white

females was 1.4 times the rate for white

males—12.4 compared with 9.2 per

100 persons (figure 1 and tables 1 and

2).

Hospital Characteristics

Injury visit rates were higher in the

Midwest compared with the South and

West geographic regions (figure 2).

Rates were similar in metropolitan and

nonmetropolitan areas. Hospitals in each

region, except the West, that are owned

by local (non-Federal) governmental

entities had a smaller proportion of their

emergency department case load for

injuries compared with hospitals that are

voluntary or proprietary (34 percent

compared with 40 percent). Tables 3 and

4 present injury visit statistics by

hospital characteristics.

Visit Characteristics

External Cause of Injury

An external cause of injury was

provided for 89 percent of the injury

visits. For 11 percent of the injury visits,

no external cause of injury was provided

on the Patient Record form, varying by

age from a low of 7.5 percent for

children 5–14 years to 15.6 percent for

persons 65 years and over. For

13 percent of injury visits, very limited

information was recorded about the

cause or mechanism of the injury,

ranging from 9 percent for children

under 5 years to 15 percent for persons

15–24 years. The nonspecific external

cause information was coded to a

category indicating that the mechanism

was not specified (tables 5–8). The

analysis presented in this section is

based upon the first-listed external cause

of injury.

Four external causes of injury—

falls, being struck by or striking against

an object or person (referred to as struck

by/against), motor vehicle traffic-related

injuries, and injuries caused by cutting

and piercing instruments or objects

(referred to as cut/pierce)—accounted

for 53 percent of all injury-related visits

to the emergency department, and for

59 percent of those visits for which an

Figure 1. Annual rate of injury-related visits to hospital emergency departments by

patient’s age, race, and sex: United States, 1992–95

Figure 2. Annual utilization rate for injuries to hospital emergency departments by

geographic region and metropolitan status of hospital: United States, 1992–95

Page 4 [ Series 13, No. 131
external cause was recorded on the

Patient Record form (figure 3).

In 1992–95, falls accounted for

21 percent of all injury visits and

24 percent of all injury visits for which

an external cause was given on the

Patient Record form. The average

annual visit rate to the emergency

department for falls was 30.6 per 1,000

persons, and it exceeded the rate for all

other specified causes. The pattern of

visits for falls can best be described as

Q-shaped with rates for children under 5

years as high as for persons 65 years

and over (figure 4). The high rate for

children under 5 years results from

higher rates for males than for females

(63.8 compared with 46.3 per 1,000

persons). The rate for white males under

5 years was higher than for white

females. At ages 65 years and over, the

high rate is a result of the visit rate

among white females, 67.4 per 1,000

persons. That rate was twice the rates

for white and black males (33.9 and

36.6 per 1,000 persons, respectively). At

ages 25–44 years, rates for the four

race-sex groups were similar (about 20

per 1,000 persons). Visit rates for falls

were about 30 percent higher in the

Midwest and Northeast than in the

South and West and were about

17 percent higher in nonmetropolitan

than metropolitan areas.

Being struck by or striking

against an object or person was the

second most often listed external cause

of injury, accounting for 12 percent of

all injury visits and 13 percent of injury

visits for which an external cause was

provided. The average annual visit rate,

16.9 per 1,000 persons, was 0.6 times

the rate for falls. The shape and

magnitude of the age, race, and sex

distributions for visits caused by being

struck by or striking against are very

different from that of fall-related visits.

For all persons, rates were highest at

ages 15–24 years (30.9 per 1,000

persons). In general, rates were higher

for males than for females, for younger

than older, and similar within sex for

white and black persons. Rates were

similarly high for white males 15–24

years (45.8 per 1,000 persons) and for

black males 15–24 and 25–44 years

(46.3 and 38.8 per 1,000 persons,

respectively). Visit rates for white and

black males under 45 years were about

twice the rates for white and black

females (figure 5). Visit rates were

higher in the Midwest than in the South

or West (20.9 compared with 15.1 and

14.8 visits per 1,000 persons,

respectively).

Motor vehicle traffic-related injury

visit rates accounted for 11 percent of

injury visits to the ED and 12 percent of

visits for which an external cause of

injury was provided. The overall visit

rate, 15.4 per 1,000 persons, was similar

to that for struck by/against and was

similarly higher for persons 15–24 years

(31.7 per 1,000 persons) than for others

(figure 6). The rates for persons 15–24

years were similar across all four

race-sex groups. For black males and

females, the visit rate for persons 25–44

years was similar to the rate for the

younger group. The motor vehicle

traffic-related visit rate for black females

25–44 years was twice the rate for white

females (33.1 compared with 15.4 per

1,000 persons) and the rates for black

males 25–44 and 45–64 years were two

and three times the respective rates for

white males (35.6 and 25.6 per 1,000

persons compared with 18.4 and 9.1 per

1,000 persons).

Visits to the emergency department

as a result of being injured by a cutting

or piercing instrument or object

accounted for 9 percent of all injury

visits and 10 percent of injury visits for

which an external cause was given on

the Patient Record form . The shape of

the distribution was similar to that for

visits resulting from being struck,

although the magnitude of the rates

(across the four race-sex groups) was

generally lower. Age-specific rates were

higher for males than for females, and

there were no differences by race (for

either males or females). Visit rates for

white and black males 15–24 and 25–44

years were two to three times the

respective rates for females (figure 7).

Looking across these specific visit

rates by age, falls accounted for nearly

40 percent of injury visits for children

under 5 years and for about 30 percent

for children 5–14 years (figure 8).

Poisoning was a more likely cause of a

visit for children under 5 years than for

other ages, and dog bites (the largest

portion of causes related to natural and

environmental conditions) were more

commonly associated with children than

with older persons. For persons 15–24

years, visit rates for falls, struck

Figure 3. Percent distribution of leading causes of injury in emergency department visits:

United States, 1992–95

Series 13, No. 131 [ Page 5
Figure 4. Emergency department visit rates for injury resulting from falls by age, race, and sex: United States, 1992–95

Figure 5. Emergency department visit rates for injury resulting from being struck by or against an object or person by age, race, and sex:

United States, 1992–95

Page 6 [ Series 13, No. 131
Figure 6. Emergency department visit rates for motor vehicle traffic-related injuries by age, race, and sex: United States, 1992–95

Figure 7. Emergency department visit rates for injury resulting from cutting or piercing instruments by age, race, and sex: United States,

1992–95

Series 13, No. 131 [ Page 7
by/against, and motor vehicle traffic

injuries were similarly high, accounting

for about 54 percent of injury visits. At

45–64 years, falls accounted for about

30 percent of all external causes of

injury, with rates 2.0 to 2.7 times the

next three causes. Finally, for persons

65 years and over, nearly 60 percent of

all injury visits were for falls, with visit

rates about 7 to 13 times the rates for

the next most common causes.

In addition to the mechanism of the

injury, the ICD–9–CM also classifies

external causes by whether the injury

was intentional or unintentional.

Intentional injuries include those caused

by someone other than the victim—as

an assault, or by the victim, as a

self-inflicted injury. They also include

other violent means such as legal

intervention or operations of war. Of all

of the injury-related visits to the

emergency department, 83 percent were

coded as unintentional and 5 percent as

intentional (4.5 percent assaultive and

0.6 percent self-inflicted). If the

remaining 11 percent of visits that did

not have an external cause on the record

(blank cause of injury) are omitted, the

distribution would be 94 percent

unintentional and 6 percent intentional.

It is very important to note that the

ICD–9–CM coding guidelines indicate

that if the Patient Record form did not

indicate the intent of the injury (for

example, the record stated ‘‘patient fell

down the stairs’’), then the intent

defaults to unintentional. This means

that intentional injury visits were only

so classified when there was specific

mention of assault or intentional

self-infliction in the medical record.

Depending on the thoroughness of

information in the medical record and

the information abstracted to the Patient

Record form, the estimates in this report

for intentional injuries are probably

underestimates, and the estimates for

unintentional injuries are probably

overestimates. In addition, patients

presenting to emergency departments

with injuries caused by domestic

violence are less likely to volunteer the

information to medical staff and may

report the injuries as unintentional

(12,13).

There were 1.9 million emergency

department visits documented in the

medical record as intentional injuries, an

average annual rate of 7.5 visits per

1,000 persons. The visit rate for

intentional injuries varied by age, sex,

and race of the patient. In general, the

rate for males was 1.5 times that for

females (9.1 compared with 5.9 per

1,000 persons) and the rate for black

persons was three times that for white

persons (table 9). Intentional injury visit

rates were lower for persons under 15

and 45 years and over compared with

rates for persons 15–24 and 25–44

years. Race and sex-specific visit rates

for intentional injuries at ages 15–24

years were twice the rates at 25–44

years except among black males (for

whom the rates were similar). Visit rates

for intentional injuries were highest for

black males and females 15–24 years

and for black males 25–44 years

(figure 9). Among persons 25–44 years

old, the visit rate for intentional injuries

for black males was more than four

times the rate for white males (41.1 and

10.1 visits per 1,000 persons,

respectively). Intentional injury visit

rates were 60 percent higher in

metropolitan than nonmetropolitan areas

(table 10).

ED injury visits by the intent and

mechanism of the first-listed external

Figure 8. Percent distribution of emergency department injury visits by mechanism that caused the injury for each age group:

United States, 1992–95

Page 8 [ Series 13, No. 131
cause of injury are shown in table 11.

Unintentional falls and unintentional

motor vehicle traffic-related injuries

accounted for the largest percentages of

injury-related ED visits (21 percent and

11 percent, respectively). ‘‘Struck

by/against’’ was the leading mechanism

for assault-related injuries (1.8 percent).

Self-inflicted injuries resulted in 221,000

annual ED visits with poisoning being

the cause for about one-half of those

visits.

The top 20 specific external cause

of injury codes at the 3-digit level help

explain some of the differences between

ages within the broader categories and

account for approximately 80 percent of

the visits with a cause provided

(tables 12 and 13). For example, among

the age groups with the highest rate for

falls, children under 5 years were more

likely to fall from one level to another

compared with persons 65 years and

over, while older persons were more

likely than children to fall on the same

level. Children 5–14 years had a higher

percent of their injury visits from pedal

cycle incidents compared with other age

groups. It should be noted that estimates

that differ in ranked order may not be

significantly different from each other.

Principal Diagnosis

The principal diagnoses in ED

injury visits were analyzed using the

major disease chapters specified by the

ICD–9–CM (8) with finer breakdowns

in the injury and poisoning chapter

(tables 14–21). Injury and poisoning

diagnoses (ICD–9–CM codes 800–999)

accounted for 80 percent of principal

diagnoses for all injury visits. Four

principal diagnoses accounted for

two-thirds of all injury visits: open

wounds, superficial injuries, sprains and

strains, and fractures (figure 10).

Principal diagnoses that were not in the

ICD–9–CM chapter on injuries

accounted for another 20 percent of

injury visits, with almost one-fifth of

these in the musculoskeletal system

chapter (ICD–9–CM codes 710–739).

Three percent of the principal diagnoses

were in the ‘‘Supplementary

Classification of Factors Influencing

Health Status and Contact with Health

Services’’ (V–codes), which includes

observations and suture removals.

Open wounds accounted for

22 percent of all principal diagnoses at

injury visits; the visit rate was 31.5 per

1,000 persons. Among children under 5

and 5–14 years, about one third of all

injury visits resulted from open wounds.

In general, visit rates for open wounds

were higher for children and young

adults than for older persons and for

males than for females. For white and

black females and white males, visit

rates resulting from open wounds were

higher among young children under 5

years than among persons in other age

groups, although among white males,

the rate at 15–24 years was similar to

the rate for children under 5 years

(figure 11). For black males, the rate at

ages 15–24 years (85.8 per 1,000

persons) was 1.4 to 1.6 times the rates

for those under 5 and 5–14 years.

Figure 9. Annual rate of emergency department visits for intentional injuries by patient’s

race, sex, and age: United States, 1992–95

Figure 10. Percent distribution of emergency department injury visits by principal

diagnosis: United States, 1992–95

Series 13, No. 131 [ Page 9
Figure 11. Emergency department visit rates for open wounds by age, race, and sex: United States, 1992–95

Figure 12. Emergency department visit rates for superficial injuries by age, race, and sex: United States, 1992–95

Page 10 [ Series 13, No. 131
Figure 13. Emergency department visit rates for sprains and strains by age, race, and sex: United States, 1992–95

Figure 14. Emergency department visit rates for fractures by age, race, and sex: United States, 1992–95

Series 13, No. 131 [ Page 11
Superficial injuries (which include

contusions) accounted for 17.5 percent

of all injury visits and occurred at a rate

of 25.1 per 1,000 persons. For all

persons, the visit rate was higher for

ages 15–24 years (41.3 per 1,000

persons) than for other ages. The rate

for white males 15–24 years was 1.3

times the rate for white females. Rates

for black males and females under 45

years were similar. For persons 25–44

years, the rates for black males and

females were 1.5 to 1.6 times the

respective rates for white persons. At

other ages, the rates by race and sex

were similar (figure 12).

Sprains and strains accounted for

15.5 percent of injury visits and

occurred at a rate of 22.2 per 1,000

persons. Visit rates for sprains and

strains were also higher for persons

15–24 years (42.6 per 1,000 persons)

than for other ages. Among black males

and females, the rates at ages 25–44

years were similar to the rates at 15–24

years, while for white males and

females, the rates at 15–24 years were

highest. Visit rates for black and white

males 15–24 years were similar

(figure 13).

Fractures accounted for 10 percent

of all injury visits, but for 21 percent of

all visits among persons 65 years and

over. The rates for persons 65 years and

over (23.4 per 1,000 persons) and for

children 5–14 years (21.6 per 1,000

persons) were similarly high and higher

than for other ages. Among children

5–14 years, the rate for white males

(29.3 per 1,000 persons) was twice the

rates for black males and white females

and three times the rate for black

females. For the elderly, the rate for

white females (33.7 per 1,000 persons)

was close to three times the rates for

black females and white males

(figure 14). The number of fracture

visits for elderly black males was too

small to calculate a stable rate.

Just as external causes varied across

ages, so too did principal diagnoses.

Among children under 5 and 5–14

years, open wounds followed by

superficial injuries were the leading

principal diagnoses, accounting for

37 percent and 48 percent, respectively,

of all principal diagnoses (figure 15).

Children under 5 years had relatively

few visits for sprains and strains, but

had more visits for intracranial injuries,

poisonings, burns, and effects of foreign

objects entering orifices than for other

ages (table 15). At ages 15–24 years and

25–44 years, sprains and strains, open

wounds, and superficial injuries

accounted for similar proportions (about

20 percent each) of injury visits. For

persons 65 years and over, about 1 of 4

injury visits had a principal diagnosis

that was not an injury.

A selection of the most frequently

reported principal diagnoses based on

the 3-digit ICD–9–CM code for

combined years 1992–95 is shown in

tables 22 and 23. Open wound of head

(ICD–9–CM code 873) had the highest

frequency and accounted for 7.2 percent

of the ED injury visits for all ages, but

for 20.2 percent of the injury visits by

children under age 5. Other head

injuries (for example, contusion of face

and intracranial injuries) accounted for

higher proportions of visits by children

under 5 years compared with other ages.

The relationships between external

cause of injury and principal diagnosis

vary (figure 16). For example, visits for

falls were more likely than other

external causes to have an associated

fracture diagnosis (23 percent), and

Figure 15. Percent distribution of emergency department injury visits by principal diagnosis for each age group: United States, 1992–95

Page 12 [ Series 13, No. 131
visits for which overexertion was the

cause of injury were likely to have a

diagnosis of a sprain or strain

(60 percent). Visits for motor vehicle

traffic-related injury were associated

most often with sprains and strains

(30 percent) and superficial injuries

(26 percent). A noninjury was the

principal diagnosis for one-fifth of the

visits for overexertion and for

one-fourth of the visits for poisoning.

Looking at external causes

associated with principal diagnoses is

also instructive (table 24). For example,

while 47 percent of visits for fractures

had an external cause of fall on the

record, only 18–25 percent of visits for

sprains/strains, open wounds, or

superficial injuries had a fall recorded as

the first-listed external cause. Similarly,

a cut or pierce was the first-listed

external cause on 34 percent of the visits

that had an open wound as the principal

diagnosis compared with 2 percent or

fewer for other principal injury

diagnoses.

Visit Disposition

Approximately 40 percent of ED

injury visits resulted in a referral to

another physician or clinic (tables 25

and 26). Return to ED as

needed/appointment was the visit

disposition for 28.2 percent of ED injury

visits, and 22.5 percent of the patients

were told to return to the referring

physician. These proportions were not

unlike those for all ED visits (14).

Injury visits that resulted in

hospitalization can be considered an

indication of injury severity; in all, they

accounted for 19 percent of all ED visits

ending in hospitalization and for

6 percent of all injury visits. Visits

resulting in hospitalization vary by the

patient’s age, the external cause, and by

the diagnosis. For example, hospital

admission increased with patient age

from 2–5 percent for persons under 45

years to 23 percent for those 65 years

and over (figure 17). The patient was

admitted to the hospital in nearly

40 percent of visits for which a firearm

was the first-listed external cause and in

24 percent of visits for poisoning. In

contrast, only 8 percent of visits for

which a motor vehicle traffic injury was

the cause resulted in admission

(figure 18). Visits with a principal

diagnosis of fracture had a higher

hospital admission rate than other

diagnoses. The admission rate for all

injury visits was 40 to 90 percent higher

in the Midwest than in other geographic

regions. Tables 27–30 present additional

statistics for injury visits resulting in

hospitalization.

While most of the ED injury visits

appear to be for nonfatal injuries,

1.7 percent of the injury visits resulted

in the patient’s death. Injury visits were

less likely to result in death compared

with illness visits (table 25). A small

proportion of those injury visits

admitted to the hospital may have

resulted in the patient’s death, however

(15).

Reason for Visit

Twenty principal reasons for visit as

stated in the patient’s (or patient

surrogate’s) own words, represented

almost one half of all injury visits

(tables 31 and 32). Lacerations and cuts

of the upper extremity and facial areas

were the leading complaints, accounting

for 11 percent of all ED injury visits.

Figure 16. Percent distribution of emergency department injury visits by principal diagnosis for selected mechanisms that caused the

injury: United States, 1992–95

Series 13, No. 131 [ Page 13
Young children under age 5 had a

higher proportion of complaints for

lacerations and cuts of the facial area

compared with all other age groups.

Males more than females were more

likely to give as a reason for visiting the

ED a complaint classified as lacerations

and cuts of the upper extremity

(8.3 percent and 4.4 percent,

respectively). Older children 5–14 years

had a higher percent of their complaints

classified as lower extremity lacerations

compared with other age groups.

Complaint distributions were similar

across all hospital characteristics.

Diagnostic and Screening

Services

About 88 percent of all ED injury

visits included one or more diagnostic

or screening services (tables 33 and 34).

For visits with diagnostic and screening

services, an average of 1.4 services

(table 33) were ordered or provided per

ED visit. The most frequently mentioned

diagnostic service was blood pressure

check, recorded at 74.5 percent of injury

visits. Other frequently mentioned

services included extremity x ray

(31.6 percent) and chest x ray

(8.1 percent). Visits by children under

age 5 years were less likely to have

diagnostic or screening services

compared with older age groups,

especially for extremity x rays. Injury

visits were more likely to have x rays

than illness visits but less likely to have

chest x rays, urinalysis, or

electrocardiograms. More than 9 out of

10 ED visits that had an extremity x ray

were for injuries.

Procedures

Procedures were ordered or

provided at 58.9 percent of ED injury

visits (tables 35 and 36). For visits with

procedures, about one procedure was

performed per visit. Wound care was the

most frequently mentioned procedure,

recorded at 29.6 percent of visits. Other

frequently mentioned procedures were

orthopedic care (20.2 percent) and

administration of intravenous fluids

(7.2 percent). Consistent with diagnosis

patterns, male patients were more likely

to receive wound care than were female

patients. As expected from the low

fracture rate, children under 5 years

were less likely to receive orthopedic

care compared with older age groups.

Injury visits were more likely to have

therapeutic procedures performed

compared with illness visits.

Medication Therapy

Medications were used at 7 of every

10 ED injury visits. Medication use

varied by patient age with younger

patients less likely than older patients to

have medications prescribed (table 37).

For example, only one-half of the visits

by patients under age 5 had medications

prescribed (table 38). Over all age

groups, there was an average of 1.2

drug mentions per ED injury visit and

1.7 mentions per injury drug visit, about

30 percent less than typically found in

illness-related emergency department

visits (16).

Various therapeutic classes of drugs

were used for medication therapy at

injury visits (figure 19). This

classification is based on the therapeutic

categories used in the NDC (11). It

should be noted that some drugs have

more than one therapeutic application.

In these cases, the drug was classified

Figure 17. Percent of emergency department injury visits resulting in hospitalization for

each age group: United States, 1992–95

Figure 18. Percent of emergency department injury visits resulting in hospitalization for

selected mechanisms that caused the injury: United States, 1992–95

Page 14 [ Series 13, No. 131
under its primary therapeutic use. Drugs

used for pain relief were listed most

frequently, accounting for 40.3 percent

of drug mentions. Antimicrobial agents

were recorded at 11.8 percent of drug

mentions, followed by immunologic

agents (8.5 percent). (See tables 39 and

40 for details.)

Twenty specific medications

accounted for one-half of the drugs

mentioned at ED injury visits. These

medications (table 41) are listed

according to the name written on the

ED Patient Record form by hospital

staff. This could be a brand name,

generic name, or therapeutic effect.

Tylenol, which is classified as a general

analgesic, was the drug most frequently

prescribed, accounting for 6.7 percent of

all ED drugs mentioned at injury visits.

Motrin, which is classified as an

antiarthritic, was ordered or prescribed

at 3.0 percent of ED injury visits.

Specific drug utilization varied by

geographic region (table 42) whereas

drug class did not vary by region

(table 40).

Providers Seen

A registered nurse and staff

physician were seen at 84.5 percent and

84.6 percent of ED injury visits,

respectively (tables 43 and 44). A

resident/intern was seen at 11.5 percent

of ED injury visits, and for 10.6 percent

of ED injury visits another physician

was seen. The patient did not see a

physician at 1.2 million ED injury visits

(3.4 percent). Providers seen varied by

geographic region and hospital

ownership, with patients in proprietary

hospitals least likely to see a

resident/intern. Patients in the West were

also less likely to see a resident/intern

compared with other regions. Patients in

metropolitan hospitals were more likely

to see a physician (staff, resident/intern,

or other) in the ED compared with

patients in nonmetropolitan hospitals

(97.0 and 95.3 percent, respectively).

The use of physician assistants and

nurse practitioners was greater for injury

visits than for illness visits since

between 46 and 47 percent of ED visits

that used these staff resources were for

injuries. This increased use of physician

assistants and nurse practitioners for

injuries was observed for all hospital

characteristics except geographic region.

Injury and illness visits were equally

likely to use nurse practitioners and

physician assistants in the West.

Expected Source of Payment

Over one-third of the injury visits

had a primary expected source of

payment of private insurance (figure 20).

Data from the 1995 NHAMCS, which

listed worker’s compensation as a

separate category, indicates that almost

one-half of the visits in the category

labeled ‘‘Other and Unknown’’ in this

report were likely to be worker’s

compensation. Detailed breakdowns for

expected source of payment are

presented in tables 45 and 46. Half of

all hospital emergency department visits

with an expected source of payment

specified as private insurance were for

injuries compared with slightly more

than one quarter of the emergency

department visits with either Medicaid

or Medicare specified. Injury visits at

voluntary, nonprofit hospitals were more

likely to be paid by private insurance

compared with non-Federal government

hospitals (36.3 versus 25.6 percent,

respectively).

Discussion

E mergency departments of general

hospitals in the United States

receive, on average, about 38

million visits annually because someone

determined that an injury had happened

that warranted medical attention. These

visits are estimated to have cost

approximately $11 billion annually,

based on emergency department cost

estimates from the 1987 Medical

Expenditure Survey (17) and inflated to

1993 using Consumer Price Index

changes from 1987 to 1993 (18).

Federal government sources would have

covered one-fourth of this expense or

$2.7 billion.

The NHAMCS ED component is an

invaluable injury surveillance tool for

advancing the field of injury control and

prevention largely because it has

produced the first national estimates of

the external causes of nonfatal injury.

The causes and diagnoses of nonfatal

injury can now be documented and

tracked, a point that is critical for injury

prevention (3). In the past, researchers

relied on analyzing injury mortality in

order to learn what caused injuries

because comparable data for nonfatal

injury were not available. Beginning in

1992, data have been available that

allow researchers and practitioners a

more complete understanding of

nonfatal injury.

However, the following limitations

of the data are important to keep in

mind.

Figure 19. Rate of drug mention by leading therapeutic class in emergency department

injury visits: United States, 1992–95

Series 13, No. 131 [ Page 15
+ Estimates are for the number of

visits and not for the number of

people injured.

+ There is no way to separate multiple

visits based on a single event (the

ED, however, is less apt than the

physician’s office to have this

problem).

+ The data on external cause and

principal diagnosis are not linked so

one can only assume that the

first-listed diagnosis is associated

with the first-listed external cause.

+ Data on cause of injury for

emergency department visits are not

sufficiently detailed to code to a

specific external cause for about

one-quarter of the visits.

+ Validity of the information on

abstracted cause of injury data has

not been evaluated; for example, it

is likely that some proportion of the

records that have injury reported as

unintentional are actually intentional.

+ There is no uniformly accepted

framework for presenting injury

morbidity data. In this report, we

have adopted the format used for

injury mortality (9). While it is

likely that the two will be similar, a

consensus among data users has yet

to be achieved.

The mortality framework does not

totally describe the morbidity situations.

For example, there are separate

categories in the mortality matrix for

‘‘firearms’’ (0.4 percent of injury visits),

‘‘other transportation’’ (0.8 percent), and

‘‘suffocation’’ (0.3 percent), while some

external cause categories with higher

frequencies for morbidity are subsumed

under ‘‘other mechanism’’ (for example,

‘‘caught in or between objects,’’

1.9 percent; and ‘‘foreign body entering

orifice,’’ 2.5 percent). These external

causes are particularly important for

children under 5 years where the

relative percent of injury visits is higher

than for older age groups (‘‘caught,’’

2.9 percent; and ‘‘foreign body,’’

3.8 percent).

One of the limitations of the

NHAMCS data for getting national

estimates on causes of nonfatal injuries

listed above is the lack of specificity in

the assigned E–codes. While the initial

year of the survey (1992) provided

E–codes for 85 percent of the injury

visits, not all of them were at sufficient

detail to help policy makers and

prevention specialists. Overall, only

43 percent of the injury records were

assigned a specific E–code. For

example, eighty-two percent of the

codes assigned to injuries from motor

vehicle traffic incidents did not specify

the category of the person injured (for

example, driver, occupant, pedestrian).

In addition, of the E–codes assigned for

firearms, 90 percent did not specify the

type of firearm. The data for 1993–95

present similar problems. It is difficult to

develop prevention strategies when the

cause of injury at a very detailed level

cannot be determined. Data from the

abstract forms were verified and a

sample was recoded by specialists to

indicate that given the information

provided on the abstract form, the

correct E–code was assigned 96 percent

of the time. The lack of specificity

results from either the medical provider

not recording complete data onto the

medical record and/or the person

abstracting the data onto the survey

form in less detail than provided in the

medical record.

A study based on 1991 hospital

emergency department data found that

only 46 percent of the cause of injury

information available from the patient

was recorded on the medical record; this

was determined by interviewing the

patients, an expensive and impractical

approach for record-based surveys (19).

The loss of information was explained

equally by the failure to obtain all of the

information at the time of history taking

and failure by the medical provider to

document the information obtained.

It also is possible that some loss of

information can occur at the time that

information is abstracted onto the

NHAMCS survey forms because of

illegible provider handwriting or

insufficient training as to how specific

the information needs to be for survey

purposes. A recent study of coding of

cause information directly from inpatient

medical records indicated that 70 percent

of the cases with a vague E–code could

be coded at a more specific level if all

the information from the medical record

was used (20). A special training session

was held with Census Bureau Field

Representatives on the amount of detail

required for completing the cause of

Figure 20. Percent distribution of injury visits to hospital emergency departments by

primary expected source of payment: United States, 1992–95

Page 16 [ Series 13, No. 131
injury item for the 1997 surveys. In

anticipation of improved information in

the cause of injury section, the verbatim

text of the cause of injury information is

being captured with the anticipation of

placing this field on the 1997 public-use

files to facilitate injury research.

The problem of getting medical

staff to probe for injury causes is more

difficult to control in this survey.

Because only a sample of the records

are abstracted, medical staff do not

know at the time of the encounter which

records will need the more detailed

information for survey purposes. It is

more a matter of the profession deciding

that probing for injury causes is vital for

every injury case seen. For example,

research has shown that 1) asking

patients about whether the injury was

related to domestic violence increased

the proportion of injury cases that were

intentional (12); and 2) reviewing the

medical record for frequent use of ED

for injuries helped to identify injuries as

resulting from possible domestic

violence (13).

Conclusion

The NHAMCS data allow

researchers to examine the

frequency of emergency

department utilization for injuries by

patient and hospital characteristics. This

report showed that external cause of

injury and principal diagnosis in injury

visits varied by patient race, sex, and

age. While the Midwest had a higher

overall visit rate for injuries compared

with other geographic regions, there was

little regional variation in external cause

or diagnoses rendered. Other hospital

characteristics, which included

metropolitan status and ownership, also

showed little variation in diagnosis or

other visit characteristics such as

diagnostic tests, treatment provided, or

disposition. Visits for injuries varied in

the severity of the injury as measured

by admission to inpatient status. The

proportion of visits ending in hospital

admission varied by patient age, external

cause of injury, and principal diagnosis.

The detailed tables in this report should

help injury prevention researchers and

hospitals answer many questions related

to emergency department utilization for

injuries. Prevention strategies should be

developed to help reduce the number of

injuries presenting to emergency

departments. And to improve their

surveillance mechanism, emergency

department staff should probe the patient

more fully to learn the cause of injury

and record the information on the

medical record.

References

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Chartbook. Health, United States,

1996–97. Hyattsville, Maryland:

National Center for Health Statistics.

1997.

2. Schappert SM. Ambulatory care visits

to physician offices, hospital outpatient

departments, and emergency

departments: United States, 1995.

National Center for Health Statistics.

Vital Health Stat 13(129). 1997.

3. National Academy of Sciences. Injury

in America. Washington D.C.: National

Academy Press. 1985.

4. Burt CW. Injury-related visits to

hospital emergency departments: United

States, 1992. Advance data from vital

and health statistics; no 261.

Hyattsville, Maryland: National Center

for Health Statistics. 1995.

5. McCaig LF, McLemore T. Plan and

operation of the National Hospital

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6. Shah BV, Barnwell BG, Hunt PN,

LaVange LM. SUDAAN user’s manual,

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North Carolina: Research Triangle

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8. Public Health Service and Health Care

Financing Administration. International

Classification of Diseases, 9th Revision,

Clinical Modification. Washington,

D.C.: Public Health Service. 1991.

9. Centers for Disease Control and

Prevention. Recommended framework

for presenting injury mortality data.

MMWR 46 (RR-14). 1997.

10. Koch H, Campbell W. The collection

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Health Statistics. Vital Health Stat

2(90). 1982.

11. Food and Drug Administration.

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edition. Washington: Public Health

Service. 1985.

12. McLeer SV, Anwaar R. A study of

battered women presenting in an

emergency department. Am J Public

Health 79:65–6. 1989.

13. Lachs S, Williams CS, O’Brien S,

Hurst L, Kossack A, Siegel A, Tinetti

ME. ED use by older victims of family

violence. Ann Emerg Med 30:448–54.

1997.

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Ambulatory Medical Care Survey: 1995

emergency department summary.

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15. Hall MJ, Owings MF. Hospitalizations

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Hyattsville, Maryland: National Center

for Health Statistics. 1994.

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1992. Advance data from vital and

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Maryland: National Center for Health

Statistics. 1997.

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household survey; ambulatory medical

visit data. Calendar year 1987.

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Kinnane JA, Coben JR. Child and

Adolescent Emergency Department

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Injury Prevention, Allegheny University

of the Health Sciences. 1997.

19. Schwartz RJ, Boisoneau BS, Jacobs

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Series 13, No. 131 [ Page 17
Table 1. Annual number, percent distribution, and rate of injury-related emergency department visits by patient characteristics, averaged

over a 4-year period: United States, 1992–95

Patient characteristic

Number of

visits in

thousands

Percent

distribution

Percent

injury

related1

Number

of visits

per 100

persons

per year2

All injury-related visits ................... 36,785 100.0 37.8 14.3

Age

Under 5 years ........................ 3,499 9.5 27.8 17.4

5–14 years .......................... 5,535 15.0 53.5 14.6

15–24 years ......................... 7,410 20.1 48.5 21.0

25–44 years ......................... 12,348 33.6 43.8 15.0

45–64 years ......................... 4,546 12.4 35.0 9.1

65 years and over ...................... 3,448 9.4 26.3 11.1

Sex and age

Female ............................ 16,239 44.1 33.8 12.3

Under 5 years ....................... 1,515 4.1 26.3 15.4

5–14 years ......................... 2,233 6.1 47.8 12.0

15–24 years ........................ 2,915 7.9 35.0 16.5

25–44 years ........................ 5,087 13.8 34.9 12.2

45–64 years ........................ 2,243 6.1 32.3 8.6

65 years and over .................... 2,247 6.1 28.6 12.4

Male .............................. 20,546 55.9 46.3 16.4

Under 5 years ....................... 1,984 5.4 29.1 19.3

5–14 years ......................... 3,302 9.0 58.2 17.0

15–24 years ........................ 4,495 12.2 64.6 25.5

25–44 years ........................ 7,260 19.7 53.3 17.9

45–64 years ........................ 2,304 6.3 38.2 9.5

65 years and over .................... 1,201 3.3 22.8 9.2

Race and age

White ............................. 29,998 81.5 41.7 14.1

Under 5 years ....................... 2,735 7.4 30.3 17.3

5–14 years ......................... 4,533 12.3 57.1 15.0

15–24 years ........................ 6,022 16.4 51.4 21.4

25–44 years ........................ 9,814 26.7 46.1 14.4

45–64 years ........................ 3,766 10.2 36.4 8.8

65 years and over .................... 3,128 8.5 27.1 11.2

Black .............................. 5,912 16.1 32.3 18.2

Under 5 years . . . . . . . . . . . . . . . . . . . . . . . 669 1.8 21.1 20.4

5–14 years . . . . . . . . . . . . . . . . . . . . . . . . . 869 2.4 41.3 14.4

15–24 years ........................ 1,231 3.3 38.6 23.3

25–44 years ........................ 2,212 6.0 35.9 21.8

45–64 years . . . . . . . . . . . . . . . . . . . . . . . . 660 1.8 28.3 12.8

65 years and over . . . . . . . . . . . . . . . . . . . . 272 0.7 19.7 10.5

All other races . . . . . . . . . . . . . . . . . . . . . . . . 875 2.4 38.1 7.7

Asian/Pacific Islander . . . . . . . . . . . . . . . . . . 624 1.7 40.0 . . .

American Indian/Eskimo/Aleut . . . . . . . . . . . . . 251 0.7 34.0 . . .

. . . Category not applicable.

1Percent of all ED visits in each category that are injury related.

2Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

Page 18 [ Series 13, No. 131
Table 2. Annual number, percent distribution, and rate of injury-related emergency department visits by patient age, race, and sex, averaged

over a 4-year period: United States, 1992–95

Sex and age

White Black1

Number of

visits in

thousands

Percent

distribution

Percent

of visits

that are

injury

related

Number

of visits

per 100

persons2

Number of

visits in

thousands

Percent

distribution

Percent

of visits

that are

injury

related

Number

of visits

per 100

persons2

Total .................. 29,997 100.0 41.7 14.1 5,912 100.0 32.3 18.2

Female ................ 13,211 44.0 35.6 12.2 2,654 44.9 27.0 15.3

Under 5 years ........... 1,164 3.9 28.3 15.1 314 5.3 21.3 19.4

5–14 years ............. 1,840 6.1 51.1 12.5 341 5.8 36.6 11.5

15–24 years ............ 2,323 7.7 37.5 16.7 527 8.9 27.4 19.2

25–44 years ............ 3,967 13.2 36.7 11.6 986 16.7 29.3 17.7

45–64 years ............ 1,861 6.2 33.8 8.4 320 5.4 24.9 11.2

65 years and over ........ 2,056 6.9 29.8 12.7 165 2.8 19.4 10.6

Male .................. 16,786 56.0 48.3 16.1 3,258 55.1 38.4 21.8

Under 5 years ........... 1,571 5.2 31.9 19.4 355 6.0 21.0 21.3

5–14 years ............. 2,693 9.0 62.0 17.4 528 8.9 45.1 17.2

15–24 years ............ 3,700 12.3 67.0 26.2 704 11.9 55.8 30.9

25–44 years ............ 5,847 19.5 55.9 17.2 1,225 20.7 43.9 26.7

45–64 years ............ 1,905 6.4 39.4 9.1 339 5.7 32.5 14.8

65 years and over ........ 1,072 3.6 23.1 9.2 107 1.8 20.3 10.3

1Estimates for races other than white and black have been omitted because of small sample sizes.

2Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

Table 3: Annual number and percent of emergency department visits that are for injuries, averaged over a 4-year period: United States,

1992–95

Geographic region Total

Metropolitan status Ownership

Metropolitan Nonmetropolitan

Voluntary,

nonprofit

Non-Federal

government Proprietary

Number of injury visits in thousands

All regions ................ 36,785 28,723 8,062 25,109 4,011 7,666

Northeast ................. 7,713 6,716 997 6,359 293 1,061

Midwest .................. 10,427 8,047 2,379 8,754 927 746

South ................... 11,565 8,143 3,421 6,143 1,579 3,843

West . . . . . . . . . . . . . . . . . . . . 7,081 5,817 1,264 3,853 1,212 2,016

Percent distribution

All regions ................ 100.0 100.0 100.0 100.0 100.0 100.0

Northeast ................. 21.0 23.4 12.4 25.3 7.3 13.8

Midwest .................. 28.3 28.0 29.5 34.9 23.1 9.7

South ................... 31.4 28.4 42.4 24.5 39.4 50.1

West . . . . . . . . . . . . . . . . . . . . 19.2 20.3 15.7 15.3 30.2 26.3

Percent distribution

All regions ................ 100.0 78.1 21.9 68.3 10.9 20.8

Northeast ................. 100.0 87.1 12.9 82.5 3.8 13.7

Midwest .................. 100.0 77.2 22.8 84.0 8.9 7.2

South ................... 100.0 70.4 29.6 53.1 13.7 33.2

West . . . . . . . . . . . . . . . . . . . . 100.0 82.1 17.9 54.4 17.1 28.5

Percent of all emergency department visits that are injury related

All regions ................ 39.8 39.9 39.5 40.8 34.4 39.8

Northeast ................. 40.8 40.4 43.7 42.1 26.8 39.6

Midwest .................. 40.8 40.4 42.2 41.4 34.9 43.4

South ................... 37.6 38.5 35.6 38.3 32.9 38.9

West . . . . . . . . . . . . . . . . . . . . 40.8 40.3 43.6 41.6 39.1 40.6

Series 13, No. 131 [ Page 19
Table 4. Annual number and percent distribution of injury-related emergency department visits by patient characterstics, according to

hospital characteristics, averaged over a 4-year period: United States, 1992–95

Patient characteristic Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury-related visits ......... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Age

Under 5 years .............. 3,499 576 1,026 1,253 644 2,826 673 2,415 325 759

5–14 years ................ 5,535 1,101 1,621 1,789 1,025 4,232 1,302 3,859 523 1,152

15–24 years ............... 7,410 1,523 2,199 2,249 1,439 5,724 1,685 5,136 787 1,487

25–44 years ............... 12,348 2,665 3,374 3,825 2,484 9,907 2,441 8,275 1,565 2,507

45–64 years ............... 4,546 1,064 1,251 1,344 888 3,511 1,035 3,064 516 967

65 years and over ............ 3,448 784 957 1,106 601 2,522 925 2,361 294 793

Sex and age

Female .................. 16,239 3,381 4,442 5,326 3,090 12,744 3,495 11,006 1,711 3,523

Under 5 years ............. 1,515 236 432 580 267 1,204 311 1,015 151 349

5–14 years ............... 2,233 458 633 725 416 1,690 543 1,547 214 472

15–24 years .............. 2,915 586 838 910 581 2,292 623 1,997 311 607

25–44 years .............. 5,087 1,046 1,333 1,672 1,036 4,144 944 3,394 628 1,065

45–64 years .............. 2,243 542 605 675 420 1,778 464 1,508 242 493

65 years and over .......... 2,247 513 601 763 370 1,637 611 1,544 165 538

Male .................... 20,546 4,332 5,984 6,239 3,991 15,979 4,566 14,103 2,300 4,143

Under 5 years ............. 1,984 340 594 672 378 1,622 362 1,399 174 411

5–14 years ............... 3,302 643 987 1,064 608 2,543 759 2,312 309 681

15–24 years .............. 4,495 937 1,361 1,339 857 3,433 1,063 3,139 476 880

25–44 years .............. 7,260 1,619 2,041 2,153 1,448 5,764 1,497 4,881 937 1,442

45–64 years .............. 2,304 521 645 668 468 1,733 571 1,556 274 474

65 years and over .......... 1,201 271 356 342 231 886 315 816 129 256

Race and age

White ................... 29,998 6,354 8,680 8,718 6,245 22,718 7,280 20,576 2,991 6,432

Under 5 years ............. 2,735 447 819 92 557 2,131 574 1,861 256 618

5–14 years ............... 4,533 943 1,327 1,353 910 3,350 1,183 3,163 408 961

15–24 years .............. 6,022 1,249 1,836 1,656 1,281 4,519 1,503 4,185 618 1,220

25–44 years .............. 9,814 2,136 2,749 2,758 2,171 7,643 2,171 6,673 1,065 2,076

45–64 years .............. 3,766 878 1,068 1,052 768 2,809 958 2,551 380 835

65 years and over .......... 3,128 701 882 987 557 2,236 892 2,143 263 721

Black .................... 5,912 1,188 1,594 2,731 399 5,294 618 3,920 935 1,057

Under 5 years . . . . . . . . . . . . . 669 110 195 326 38 585 84 480 67 122

5–14 years . . . . . . . . . . . . . . . 869 134 262 421 51 779 90 602 103 163

15–24 years .............. 1,231 247 330 575 79 1,086 145 835 156 241

25–44 years .............. 2,212 459 576 1,012 165 1,993 219 1,387 459 366

45–64 years . . . . . . . . . . . . . . 660 167 161 279 53 608 52 431 122 107

65 years and over . . . . . . . . . . 272 71 70 118 12 243 29 185 29 58

All other races . . . . . . . . . . . . . . 875 171 153 115 436 712 164 614 85 176

Asian/Pacific Islander . . . . . . . . 624 133 81 95 315 586 39 433 54 138

American Indian/Eskimo/Aleut . . . 251 38 72 20 121 126 125 181 31 39

Page 20 [ Series 13, No. 131
Table 4. Annual number and percent distribution of injury-related emergency department visits by patient characterstics, according to

hospital characteristics, averaged over a 4-year period: United States, 1992–95—Con.

Patient characteristic Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Percent distribution

All injury-related visits ......... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Age

Under 5 years . . . . . . . . . . . . . . 9.5 7.5 9.8 10.8 9.1 9.8 8.4 9.6 8.1 9.9

5–14 years ................ 15.0 14.3 15.5 15.5 14.5 14.7 16.2 15.4 13.0 15.0

15–24 years ............... 20.1 19.7 21.1 19.4 20.3 19.9 20.9 20.5 19.6 19.4

25–44 years ............... 33.6 34.6 32.4 33.1 35.1 34.5 30.3 33.0 39.0 32.7

45–64 years ............... 12.4 13.8 12.0 11.6 12.5 12.2 12.8 12.2 12.9 12.6

65 years and over . . . . . . . . . . . . 9.4 10.2 9.2 9.6 8.5 8.8 11.5 9.4 7.3 10.4

Sex and age

Female .................. 44.1 43.8 42.6 46.1 43.6 44.4 43.4 43.8 42.7 46.0

Under 5 years . . . . . . . . . . . . . 4.1 3.1 4.1 5.0 3.8 4.2 3.9 4.0 3.8 4.5

5–14 years . . . . . . . . . . . . . . . 6.1 5.9 6.1 6.3 5.9 5.9 6.7 6.2 5.3 6.2

15–24 years . . . . . . . . . . . . . . 7.9 7.6 8.0 7.9 8.2 8.0 7.7 8.0 7.8 7.9

25–44 years .............. 13.8 13.6 12.8 14.5 14.6 14.4 11.7 13.5 15.7 13.9

45–64 years . . . . . . . . . . . . . . 6.1 7.0 5.8 5.8 5.9 6.2 5.8 6.0 6.0 6.4

65 years and over . . . . . . . . . . 6.1 6.7 5.8 6.6 5.2 5.7 7.6 6.2 4.1 7.0

Male .................... 55.9 56.2 57.4 53.9 56.4 55.6 56.6 56.2 57.3 54.0

Under 5 years . . . . . . . . . . . . . 5.4 4.4 5.7 5.8 5.3 5.6 4.5 5.6 4.3 5.4

5–14 years . . . . . . . . . . . . . . . 9.0 8.3 9.5 9.2 8.6 8.9 9.4 9.2 7.7 8.9

15–24 years .............. 12.2 12.2 13.1 11.6 12.1 12.0 13.2 12.5 11.9 11.5

25–44 years .............. 19.7 21.0 19.6 18.6 20.4 20.1 18.6 19.4 23.4 18.8

45–64 years . . . . . . . . . . . . . . 6.3 6.8 6.2 5.8 6.6 6.0 7.1 6.2 6.8 6.2

65 years and over . . . . . . . . . . 3.3 3.5 3.4 3.0 3.3 3.1 3.9 3.3 3.2 3.3

Race and age

White ................... 81.5 82.4 83.3 75.4 88.2 79.1 90.3 81.9 74.6 83.9

Under 5 years . . . . . . . . . . . . . 7.4 5.8 7.9 0.8 7.9 7.4 7.1 7.4 6.4 8.1

5–14 years ............... 12.3 12.2 12.7 11.7 12.9 11.7 14.7 12.6 10.2 12.5

15–24 years .............. 16.4 16.2 17.6 14.3 18.1 15.7 18.6 16.7 15.4 15.9

25–44 years .............. 26.7 27.7 26.4 23.9 30.7 26.6 26.9 26.6 26.6 27.1

45–64 years .............. 10.2 11.4 10.2 9.1 10.9 9.8 11.9 10.2 9.5 10.9

65 years and over . . . . . . . . . . 8.5 9.1 8.5 8.5 7.9 7.8 11.1 8.5 6.6 9.4

Black .................... 16.1 15.4 15.3 23.6 5.6 18.4 7.7 15.6 23.3 13.8

Under 5 years . . . . . . . . . . . . . 1.8 1.4 1.9 2.8 0.5 2.0 1.0 1.9 1.7 1.6

5–14 years . . . . . . . . . . . . . . . 2.4 1.7 2.5 3.6 0.7 2.7 1.1 2.4 2.6 2.1

15–24 years . . . . . . . . . . . . . . 3.3 3.2 3.2 5.0 1.1 3.8 1.8 3.3 3.9 3.1

25–44 years . . . . . . . . . . . . . . 6.0 5.9 5.5 8.8 2.3 6.9 2.7 5.5 11.4 4.8

45–64 years . . . . . . . . . . . . . . 1.8 2.2 1.5 2.4 0.7 2.1 0.6 1.7 3.0 1.4

65 years and over . . . . . . . . . . 0.7 0.9 0.7 1.0 0.2 0.8 0.4 0.7 0.7 0.8

All other races . . . . . . . . . . . . . . 2.4 2.2 1.5 1.0 6.2 2.5 2.0 2.4 2.1 2.3

Asian/Pacific Islander . . . . . . . . 1.7 1.7 0.8 0.8 4.4 2.0 0.5 1.7 1.3 1.8

American Indian/Eskimo/Aleut . . . 0.7 0.5 0.7 0.2 1.7 0.4 1.6 0.7 0.8 0.5

Series 13, No. 131 [ Page 21
Table 5. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the injury,

according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95

Mechanism Total

Patient age Sex Race2

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits .............. 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Fall ..................... 7,847 1,109 1,393 937 1,756 1,034 1,619 4,057 3,791 6,735 937

Struck by or against a person or

object ................... 4,351 376 865 1,090 1,487 399 135 1,499 2,852 3,555 697

Motor vehicle traffic ........... 3,956 149 363 1,119 1,553 527 245 1,969 1,987 3,058 779

Cut/pierce ................. 3,189 166 497 723 1,294 385 123 1,034 2,155 2,585 496

Overexertion ............... 1,597 49 103 364 790 229 62 671 926 1,367 211

Natural/environmental ......... 1,503 193 333 229 442 185 120 696 808 128 196

Poisoning . . . . . . . . . . . . . . . . . 877 154 64 208 331 79 41 477 400 700 155

Fire/burn . . . . . . . . . . . . . . . . . 597 103 52 129 228 67 * 234 364 468 115

Other pedal cycle . . . . . . . . . . . . 493 52 282 72 65 * * 151 342 432 50

Machinery . . . . . . . . . . . . . . . . . 314 * * 76 130 68 * 73 241 281 26

Firearm . . . . . . . . . . . . . . . . . . 164 * * 61 70 * * 17 146 78 85

Other transportation . . . . . . . . . . . 287 * 50 83 104 30 * 104 183 262 *

Suffocation . . . . . . . . . . . . . . . . 98 54 * * * * * 53 44 79 *

Other mechanism1 ........... 2,065 304 362 378 704 253 64 855 1,210 1,721 291

Not elsewhere classified . . . . . . . . 433 26 74 153 146 25 * 178 255 342 76

Mechanism not specified ....... 4,861 327 650 1,091 1,760 606 425 2,129 2,732 3,819 941

Blank cause of injury .......... 4,154 418 413 682 1,480 621 539 2,044 2,110 3,231 824

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Fall ..................... 21.3 31.7 25.2 12.6 14.2 22.7 46.9 25.0 18.4 22.5 15.9

Struck by or against a person or

object . . . . . . . . . . . . . . . . . . . 11.8 10.7 15.6 14.7 12.0 8.8 3.9 9.2 13.9 11.9 11.8

Motor vehicle traffic ........... 10.8 4.3 6.6 15.1 12.6 11.6 7.1 12.1 9.7 10.2 13.2

Cut/pierce . . . . . . . . . . . . . . . . . 8.7 4.7 9.0 9.8 10.5 8.5 3.6 6.4 10.5 8.6 8.4

Overexertion . . . . . . . . . . . . . . . 4.3 1.4 1.9 4.9 6.4 5.0 1.8 4.1 4.5 4.6 3.6

Natural/environmental . . . . . . . . . 4.1 5.5 6.0 3.1 3.6 4.1 3.5 4.3 3.9 4.3 3.3

Poisoning . . . . . . . . . . . . . . . . . 2.4 4.4 1.2 2.8 2.7 1.7 1.2 2.9 1.9 2.3 2.6

Fire/burn . . . . . . . . . . . . . . . . . 1.6 3.0 0.9 1.7 1.9 1.5 * 1.4 1.8 1.6 2.0

Other pedal cycle . . . . . . . . . . . . 1.3 1.5 5.1 1.0 0.5 * * 0.9 1.7 1.4 0.8

Machinery . . . . . . . . . . . . . . . . . 0.9 * * 1.0 1.1 1.5 * 0.5 1.2 0.9 0.4

Firearm . . . . . . . . . . . . . . . . . . 0.4 * * 0.8 0.6 * * 0.1 0.7 0.3 1.4

Other transportation . . . . . . . . . . . 0.8 * 0.9 1.1 0.8 0.7 * 0.6 0.9 0.9 *

Suffocation . . . . . . . . . . . . . . . . 0.3 1.6 * * * * * 0.3 0.2 0.3 *

Other mechanism1 . . . . . . . . . . . 5.6 8.7 6.5 5.1 5.7 5.6 1.9 5.3 5.9 5.7 4.9

Not elsewhere classified . . . . . . . . 1.2 0.7 1.3 2.1 1.2 0.5 * 1.1 1.2 1.1 1.3

Mechanism not specified ....... 13.2 9.4 11.7 14.7 14.3 13.3 12.3 13.1 13.3 12.7 15.9

Blank cause of injury . . . . . . . . . . 11.3 11.9 7.5 9.2 12.0 13.7 15.6 12.6 10.3 10.8 13.9

Number of visits per 1,000 persons

All injury visits .............. 143.2 174.3 145.7 210.1 150.2 90.7 110.7 123.2 164.4 140.8 181.9

Fall ..................... 30.6 55.2 36.7 26.6 21.4 20.6 52.0 30.8 30.3 31.6 28.8

Struck by or against a person or

object ................... 16.9 18.7 22.8 30.9 18.1 8.0 4.3 11.4 22.8 16.7 21.4

Motor vehicle traffic ........... 15.4 7.4 9.6 31.7 18.9 10.5 7.9 14.9 15.9 14.4 24.0

Cut/pierce ................. 12.4 8.3 13.1 20.5 15.7 7.7 3.9 7.8 17.2 12.1 15.3

Overexertion . . . . . . . . . . . . . . . 6.2 2.4 2.7 10.3 9.6 4.6 2.0 5.1 7.4 6.4 6.5

Natural/environmental . . . . . . . . . 5.9 9.6 8.8 6.5 5.4 3.7 3.9 5.3 6.5 0.6 6.0

Poisoning . . . . . . . . . . . . . . . . . 3.4 7.7 1.7 5.9 4.0 1.6 1.3 3.6 3.2 3.3 4.8

Fire/burn . . . . . . . . . . . . . . . . . 2.3 5.1 1.4 3.7 2.8 1.3 * 1.8 2.9 2.2 3.5

Other pedal cycle . . . . . . . . . . . . 1.9 2.6 7.4 2.0 0.8 * * 1.1 2.7 2.0 1.5

Machinery . . . . . . . . . . . . . . . . . 1.2 * * 2.2 1.6 1.4 * 0.6 1.9 1.3 0.8

Firearm . . . . . . . . . . . . . . . . . . 0.6 * * 1.7 0.9 * * 0.1 1.2 0.4 2.6

Other transportation . . . . . . . . . . . 1.1 * 1.3 2.4 1.3 0.6 * 0.8 1.5 1.2 *

Suffocation . . . . . . . . . . . . . . . . 0.4 2.7 * * * * * 0.4 0.4 0.4 *

Other mechanism1 . . . . . . . . . . . 8.0 15.1 9.5 10.7 8.6 5.0 2.1 6.5 9.7 8.1 9.0

Not elsewhere classified . . . . . . . . 1.7 1.3 1.9 4.3 1.8 0.5 * 1.4 2.0 1.6 2.3

Mechanism not specified ....... 18.9 16.3 17.1 30.9 21.4 12.1 13.6 16.1 21.9 17.9 29.0

Blank cause of injury .......... 16.2 20.8 10.9 19.3 18.0 12.4 17.3 15.5 16.9 15.2 25.4

* Figure does not meet standard of reliability or precision.

1Includes other pedestrian and drowning.

2Estimates other than white and black have been omitted because of small sample sizes.

Page 22 [ Series 13, No. 131
Table 6. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the injury,

according to patient sex and age, averaged over a 4-year period: United States, 1992–95

Mechanism Total

Female Male

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Number of visits in thousands

All injury visits .............. 36,785 1,515 2,233 2,914 5,087 2,243 2,247 1,984 3,302 4,495 7,260 2,304 1,201

Fall ..................... 7,847 454 609 406 857 555 1,176 655 784 530 900 479 443

Struck by or against a person or

object ................... 4,351 132 272 324 510 175 87 244 592 766 977 225 48

Motor vehicle traffic ........... 3,956 70 161 584 729 272 153 80 202 535 824 255 92

Cut/pierce ................. 3,189 55 184 185 407 157 46 111 314 538 887 227 78

Overexertion ............... 1,597 27 51 148 292 114 39 22 52 216 498 115 *

Natural/environmental ......... 1,503 97 138 92 203 96 71 96 195 138 239 90 50

Poisoning . . . . . . . . . . . . . . . . . 877 71 49 115 171 50 20 83 15 93 160 29 *

Fire/burn . . . . . . . . . . . . . . . . . 597 40 * 45 88 25 * 64 28 84 140 43 *

Other pedal cycle . . . . . . . . . . . . 493 * * * * * * 35 201 46 46 * *

Machinery . . . . . . . . . . . . . . . . . 314 * * * 21 * * * * 54 101 53 *

Firearm . . . . . . . . . . . . . . . . . . 164 * * * * * * * * 58 62 * *

Other transportation . . . . . . . . . . . 287 * * 24 37 * * * * 59 67 * *

Suffocation . . . . . . . . . . . . . . . . 98 35 * * * * * * * * * * *

Other mechanism1 ........... 2,065 164 167 163 233 94 35 140 196 215 471 159 29

Not elsewhere classified . . . . . . . . 433 * 32 64 44 * * * 42 89 102 * *

Mechanism not specified ....... 4,861 155 240 400 757 310 267 173 410 691 1,003 296 159

Blank cause of injury .......... 4,154 182 190 308 703 340 320 236 222 374 777 281 219

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Fall ..................... 21.3 30.0 27.3 13.9 16.8 24.8 52.3 33.0 23.7 11.8 12.4 20.8 36.9

Struck by or against a person or

object . . . . . . . . . . . . . . . . . . . 11.8 8.7 12.2 11.1 10.0 7.8 3.9 12.3 17.9 17.0 13.5 9.8 4.0

Motor vehicle traffic ........... 10.8 4.6 7.2 20.0 14.3 12.1 6.8 4.0 6.1 11.9 11.3 11.1 7.7

Cut/pierce . . . . . . . . . . . . . . . . . 8.7 3.6 8.2 6.3 8.0 7.0 2.0 5.6 9.5 12.0 12.2 9.9 6.5

Overexertion . . . . . . . . . . . . . . . 4.3 1.8 2.3 5.1 5.7 5.1 1.7 1.1 1.6 4.8 6.9 5.0 *

Natural/environmental . . . . . . . . . 4.1 6.4 6.2 3.2 4.0 4.3 3.1 4.8 5.9 3.1 3.3 3.9 4.2

Poisoning . . . . . . . . . . . . . . . . . 2.4 4.7 2.2 3.9 3.4 2.2 0.9 4.2 0.4 2.1 2.2 1.3 *

Fire/burn . . . . . . . . . . . . . . . . . 1.6 2.6 * 1.5 1.7 1.1 * 3.2 0.8 1.9 1.9 1.8 *

Other pedal cycle . . . . . . . . . . . . 1.3 * 3.6 * * * * 1.7 6.1 1.0 0.6 * *

Machinery . . . . . . . . . . . . . . . . . 0.9 * * * 0.6 * * * * 1.2 1.4 2.3 *

Firearm . . . . . . . . . . . . . . . . . . 0.4 * * * * * * * * 1.3 0.9 * *

Other transportation . . . . . . . . . . . 0.8 * * 0.8 0.7 * * * * 1.3 0.9 * *

Suffocation . . . . . . . . . . . . . . . . 0.3 2.3 * * * * * * * * * * *

Other mechanism1 . . . . . . . . . . . 5.6 10.8 7.5 5.6 4.6 4.2 1.6 7.0 5.9 4.8 6.5 6.9 2.4

Not elsewhere classified . . . . . . . . 1.2 * 1.4 2.2 0.9 * * * 1.3 2.0 1.4 * *

Mechanism not specified ....... 13.2 10.2 10.8 13.7 14.9 13.8 11.9 8.7 12.4 15.4 13.8 12.9 13.2

Blank cause of injury . . . . . . . . . . 11.3 12.0 8.5 10.6 13.8 15.2 14.2 11.9 6.7 8.3 10.7 12.2 18.2

Number of visits per 1,000 persons

All injury visits .............. 143.2 154.5 120.4 165.2 121.8 86.4 124.0 193.1 169.8 255.1 179.4 95.4 92.2

Fall ..................... 30.6 46.3 32.8 23.0 20.5 21.4 64.9 63.8 40.3 30.1 22.2 19.8 34.0

Struck by or against a person or

object ................... 16.9 13.5 14.7 18.4 12.2 6.7 4.8 23.8 30.4 43.5 24.1 9.3 3.7

Motor vehicle traffic ........... 15.4 7.1 8.7 33.1 17.5 10.5 8.4 7.8 10.4 30.4 20.4 10.6 7.1

Cut/pierce ................. 12.4 5.6 9.9 10.5 9.7 6.0 2.5 10.8 16.1 30.5 21.9 9.4 6.0

Overexertion . . . . . . . . . . . . . . . 6.2 2.8 2.7 8.4 7.0 4.4 2.2 2.1 2.7 12.3 12.3 4.8 *

Natural/environmental . . . . . . . . . 5.9 9.9 7.4 5.2 4.9 3.7 3.9 9.3 10.0 7.8 5.9 3.7 3.8

Poisoning . . . . . . . . . . . . . . . . . 3.4 7.2 2.6 6.5 4.1 1.9 1.1 8.1 0.8 5.3 4.0 1.2 *

Fire/burn . . . . . . . . . . . . . . . . . 2.3 4.1 * 2.6 2.1 1.0 * 6.2 1.4 4.8 3.5 1.8 *

Other pedal cycle . . . . . . . . . . . . 1.9 * * * * * * 3.4 10.3 2.6 1.1 * *

Machinery . . . . . . . . . . . . . . . . . 1.2 * * * * * * * * 3.1 2.5 2.2 *

Firearm . . . . . . . . . . . . . . . . . . 0.6 * * * * * * * * 3.3 1.5 * *

Other transportation . . . . . . . . . . . 1.1 * * 1.4 0.9 * * * * 3.3 1.7 * *

Suffocation . . . . . . . . . . . . . . . . 0.4 3.6 * * * * * * * * * * *

Other mechanism1 . . . . . . . . . . . 8.0 16.7 9.0 9.2 5.6 3.6 1.9 13.6 10.1 12.2 11.6 6.6 2.2

Not elsewhere classified . . . . . . . . 1.7 * 1.7 3.6 1.1 * * * 2.2 5.1 2.5 * *

Mechanism not specified ....... 18.9 15.8 12.9 22.7 18.1 11.9 14.7 16.8 21.1 39.2 24.8 12.3 12.2

Blank cause of injury .......... 16.2 18.6 10.2 17.5 16.8 13.1 17.7 23.0 11.4 21.2 19.2 11.6 16.8

* Figure does not meet standard of reliability or precision.

1Includes other pedestrian and drowning.

Series 13, No. 131 [ Page 23
Table 7. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the injury,

according to patient race and age, averaged over a 4-year period: United States, 1992–95

Mechanism Total

White Black

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Number of visits in thousands

All injury visits .............. 36,785 2,735 4,533 6,022 9,814 3,766 3,128 669 869 1,231 2,212 660 272

Fall ..................... 7,847 896 1,168 802 1,500 884 1,485 179 191 121 218 120 110

Struck by or against a person or

object ................... 4,351 303 720 908 1,163 341 119 67 120 164 284 50 *

Motor vehicle traffic ........... 3,956 111 260 903 1,148 414 221 33 87 191 347 99 *

Cut/pierce ................. 3,189 117 396 580 1,053 330 108 40 90 121 197 40 *

Overexertion ............... 1,597 43 84 315 672 193 60 * 16 46 107 35 *

Natural/environmental ......... 1,503 157 277 192 382 166 112 33 52 34 56 * *

Poisoning . . . . . . . . . . . . . . . . . 877 118 50 172 257 70 33 35 * 29 64 * *

Fire/burn . . . . . . . . . . . . . . . . . 597 71 39 111 174 57 * 29 * * 50 * *

Other pedal cycle . . . . . . . . . . . . 493 46 252 60 55 * * * 27 * * * *

Machinery . . . . . . . . . . . . . . . . . 314 * * 61 117 67 * * * * * * *

Firearm . . . . . . . . . . . . . . . . . . 164 * * 20 37 * * * * 41 32 * *

Other transportation . . . . . . . . . . . 287 * 43 78 95 * * * * * * * *

Suffocation . . . . . . . . . . . . . . . . 98 43 * * * * * * * * * * *

Other mechanism1 ........... 2,065 233 303 319 597 215 55 58 52 50 94 29 *

Not elsewhere classified . . . . . . . . 433 * 60 110 119 * * * * 33 24 * *

Mechanism not specified ....... 4,861 247 536 842 1,333 476 385 78 103 229 380 113 38

Blank cause of injury .......... 4,154 312 320 537 1,108 476 478 96 81 130 332 130 56

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Fall ..................... 21.3 32.8 25.8 13.3 15.3 23.5 47.5 26.7 22.0 9.8 9.8 18.2 40.3

Struck by or against a person or

object . . . . . . . . . . . . . . . . . . . 11.8 11.1 15.9 15.1 11.8 9.1 3.8 10.0 13.8 13.3 12.9 7.6 *

Motor vehicle traffic ........... 10.8 4.1 5.7 15.0 11.7 11.0 7.1 4.9 10.0 15.5 15.7 15.0 *

Cut/pierce . . . . . . . . . . . . . . . . . 8.7 4.3 8.7 9.6 10.7 8.8 3.5 6.0 10.4 9.8 8.9 6.0 *

Overexertion . . . . . . . . . . . . . . . 4.3 1.6 1.9 5.2 6.8 5.1 1.9 * 1.9 3.8 4.8 5.4 *

Natural/environmental . . . . . . . . . 4.1 5.7 6.1 3.2 3.9 4.4 3.6 4.9 6.0 2.7 2.5 * *

Poisoning . . . . . . . . . . . . . . . . . 2.4 4.3 1.1 2.9 2.6 1.9 1.1 5.2 * 2.3 2.9 * *

Fire/burn . . . . . . . . . . . . . . . . . 1.6 2.6 0.9 1.8 1.8 1.5 * 4.3 * * 2.2 * *

Other pedal cycle . . . . . . . . . . . . 1.3 1.7 5.6 1.0 0.6 * * * 3.1 * * * *

Machinery . . . . . . . . . . . . . . . . . 0.9 * * 1.0 1.2 1.8 * * * * * * *

Firearm . . . . . . . . . . . . . . . . . . 0.4 * * 0.3 0.4 * * * * 3.3 1.5 * *

Other transportation . . . . . . . . . . . 0.8 * 1.0 1.3 1.0 * * * * * * * *

Suffocation . . . . . . . . . . . . . . . . 0.3 1.6 * * * * * * * * * * *

Other mechanism1 . . . . . . . . . . . 5.6 8.5 6.7 5.3 6.1 5.7 1.7 8.7 6.0 4.1 4.2 4.4 *

Not elsewhere classified . . . . . . . . 1.2 * 1.3 1.8 1.2 * * * * 2.7 1.1 * *

Mechanism not specified ....... 13.2 9.0 11.8 14.0 13.6 12.6 12.3 11.6 11.9 18.6 17.2 17.2 14.1

Blank cause of injury . . . . . . . . . . 11.3 11.4 7.1 8.9 11.3 12.6 15.3 14.3 9.3 10.5 15.0 19.7 20.5

Number of visits per 1,000 persons

All injury visits .............. 143.2 173.0 150.3 214.5 144.2 87.5 112.3 203.5 144.0 233.3 217.7 128.3 104.7

Fall ..................... 30.6 56.7 38.7 28.6 22.0 20.5 53.3 54.5 31.7 22.9 21.5 23.3 42.3

Struck by or against a person or

object ................... 16.9 19.2 23.9 32.3 17.1 7.9 4.3 20.4 19.9 31.1 28.0 9.7 *

Motor vehicle traffic ........... 15.4 7.0 8.6 32.2 16.9 9.6 7.9 10.0 14.4 36.2 34.2 19.2 *

Cut/pierce ................. 12.4 7.4 13.1 20.7 15.5 7.7 3.9 12.2 14.9 22.9 19.4 7.8 *

Overexertion . . . . . . . . . . . . . . . 6.2 2.7 2.8 11.2 9.9 4.5 2.2 * 2.7 8.7 10.5 6.8 *

Natural/environmental . . . . . . . . . 5.9 9.9 9.2 6.8 5.6 3.9 4.0 10.0 8.6 6.4 5.5 * *

Poisoning . . . . . . . . . . . . . . . . . 3.4 7.5 1.7 6.1 3.8 1.6 1.2 10.6 * 5.5 6.3 * *

Fire/burn . . . . . . . . . . . . . . . . . 2.3 4.5 1.3 4.0 2.6 1.3 * 8.8 * * 4.9 * *

Other pedal cycle . . . . . . . . . . . . 1.9 2.9 8.4 2.1 0.8 * * * 4.5 * * * *

Machinery . . . . . . . . . . . . . . . . . 1.2 * * 2.2 1.7 1.6 * * * * * * *

Firearm . . . . . . . . . . . . . . . . . . 0.6 * * 0.7 0.5 * * * * 7.8 3.1 * *

Other transportation . . . . . . . . . . . 1.1 * 1.4 2.8 1.4 * * * * * * * *

Suffocation . . . . . . . . . . . . . . . . 0.4 2.7 * * 0.0 * * * * * * * *

Other mechanism1 . . . . . . . . . . . 8.0 14.7 10.0 11.4 8.8 5.0 2.0 17.6 8.6 9.5 9.3 5.6 *

Not elsewhere classified . . . . . . . . 1.7 * 2.0 3.9 1.7 * * * * 6.3 2.4 * *

Mechanism not specified ....... 18.9 15.6 17.8 30.0 19.6 11.1 13.8 23.7 17.1 43.4 37.4 22.0 14.6

Blank cause of injury .......... 16.2 19.7 10.6 19.1 16.3 11.1 17.2 29.2 13.4 24.6 32.7 25.3 21.6

* Figure does not meet standard of reliability or precision.

1Includes other pedestrian and drowning.

Page 24 [ Series 13, No. 131
Table 8: Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the injury,

according to hospital characteristics, averaged over a 4-year period: United States, 1992–95

Mechanism Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits .............. 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Fall ..................... 7,847 1,701 2,302 2,392 1,453 5,965 1,882 5,491 715 1,641

Struck by or against a person or

object ................... 4,351 897 1,299 1,319 836 3,449 902 3,043 454 854

Motor vehicle traffic ........... 3,956 778 1,030 1,458 690 3,208 748 2,646 468 843

Cut/pierce ................. 3,189 699 884 933 673 2,490 699 2,162 319 708

Overexertion ............... 1,597 343 479 457 319 1,256 341 1,135 132 330

Natural/environmental ......... 1,503 347 372 509 275 1,133 370 984 171 348

Poisoning . . . . . . . . . . . . . . . . . 877 160 277 254 186 697 180 575 111 191

Fire/burn . . . . . . . . . . . . . . . . . 597 110 187 194 106 476 121 420 63 114

Other pedal cycle . . . . . . . . . . . . 493 116 144 105 128 395 98 343 48 101

Machinery . . . . . . . . . . . . . . . . . 314 61 126 87 41 202 112 235 * 60

Firearm . . . . . . . . . . . . . . . . . . 164 * 49 69 35 145 * 97 44 *

Other transportation . . . . . . . . . . . 287 43 85 83 77 174 114 185 30 73

Suffocation . . . . . . . . . . . . . . . . 98 * 33 32 * 64 * 82 * *

Other mechanism1 ........... 2,065 448 605 579 433 1,589 476 1,443 213 409

Not elsewhere classified . . . . . . . . 433 107 144 93 89 350 83 328 27 78

Mechanism not specified ....... 4,861 1,026 1,263 1,619 953 3,805 1,055 3,170 624 1,066

Blank cause of injury .......... 4,154 855 1,150 1,383 765 3,324 829 2,771 567 815

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Fall ..................... 21.3 22.0 22.1 20.7 20.5 20.8 23.3 21.9 17.8 21.4

Struck by or against a person or

object . . . . . . . . . . . . . . . . . . . 11.8 11.6 12.5 11.4 11.8 12.0 11.2 12.1 11.3 11.1

Motor vehicle traffic ........... 10.8 10.1 9.9 12.6 9.7 11.2 9.3 10.5 11.7 11.0

Cut/pierce . . . . . . . . . . . . . . . . . 8.7 9.1 8.5 8.1 9.5 8.7 8.7 8.6 7.9 9.2

Overexertion . . . . . . . . . . . . . . . 4.3 4.4 4.6 3.9 4.5 4.4 4.2 4.5 3.3 4.3

Natural/environmental . . . . . . . . . 4.1 4.5 3.6 4.4 3.9 3.9 4.6 3.9 4.3 4.5

Poisoning . . . . . . . . . . . . . . . . . 2.4 2.1 2.7 2.2 2.6 2.4 2.2 2.3 2.8 2.5

Fire/burn . . . . . . . . . . . . . . . . . 1.6 1.4 1.8 1.7 1.5 1.7 1.5 1.7 1.6 1.5

Other pedal cycle . . . . . . . . . . . . 1.3 1.5 1.4 0.9 1.8 1.4 1.2 1.4 1.2 1.3

Machinery . . . . . . . . . . . . . . . . . 0.9 0.8 1.2 0.8 0.6 0.7 1.4 0.9 * 0.8

Firearm . . . . . . . . . . . . . . . . . . 0.4 * 0.5 0.6 0.5 0.5 * 0.4 1.1 *

Other transportation . . . . . . . . . . . 0.8 0.6 0.8 0.7 1.1 0.6 1.4 0.7 0.7 1.0

Suffocation . . . . . . . . . . . . . . . . 0.3 * 0.3 0.3 * 0.2 * 0.3 * *

Other mechanism1 . . . . . . . . . . . 5.6 5.8 5.8 5.0 6.1 5.5 5.9 5.7 5.3 5.3

Not elsewhere classified . . . . . . . . 1.2 1.4 1.4 0.8 1.3 1.2 1.0 1.3 0.7 1.0

Mechanism not specified ....... 13.2 13.3 12.1 14.0 13.5 13.2 13.1 12.6 15.6 13.9

Blank cause of injury . . . . . . . . . . 11.3 11.1 11.0 12.0 10.8 11.6 10.3 11.0 14.1 10.6

Number of visits per 1,000 persons

All injury visits .............. 143.2 152.7 167.5 132.1 125.4 142.1 147.6 . . . . . . . . .

Fall ..................... 30.6 33.7 37.0 27.3 25.7 29.5 34.5 . . . . . . . . .

Struck by or against a person or

object ................... 16.9 17.8 20.9 15.1 14.8 17.1 16.5 . . . . . . . . .

Motor vehicle traffic ........... 15.4 15.4 16.6 16.6 12.2 15.9 13.7 . . . . . . . . .

Cut/pierce ................. 12.4 13.8 14.2 10.7 11.9 12.3 12.8 . . . . . . . . .

Overexertion . . . . . . . . . . . . . . . 6.2 6.8 7.7 5.2 5.6 6.2 6.2 . . . . . . . . .

Natural/environmental . . . . . . . . . 5.9 6.9 6.0 5.8 4.9 5.6 6.8 . . . . . . . . .

Poisoning . . . . . . . . . . . . . . . . . 3.4 3.2 4.4 2.9 3.3 3.4 3.3 . . . . . . . . .

Fire/burn . . . . . . . . . . . . . . . . . 2.3 2.2 3.0 2.2 1.9 2.4 2.2 . . . . . . . . .

Other pedal cycle . . . . . . . . . . . . 1.9 2.3 2.3 1.2 2.3 2.0 1.8 . . . . . . . . .

Machinery . . . . . . . . . . . . . . . . . 1.2 1.2 2.0 1.0 0.7 1.0 2.0 . . . . . . . . .

Firearm . . . . . . . . . . . . . . . . . . 0.6 * 0.8 0.8 0.6 0.7 * . . . . . . . . .

Other transportation . . . . . . . . . . . 1.1 0.8 1.4 0.9 1.4 0.9 2.1 . . . . . . . . .

Suffocation . . . . . . . . . . . . . . . . 0.4 * 0.5 0.4 * 0.3 * . . . . . . . . .

Other mechanism1 . . . . . . . . . . . 8.0 8.9 9.7 6.6 7.7 7.9 8.7 . . . . . . . . .

Not elsewhere classified . . . . . . . . 1.7 2.1 2.3 1.1 1.6 1.7 1.5 . . . . . . . . .

Mechanism not specified ....... 18.9 20.3 20.3 18.5 16.9 18.8 19.3 . . . . . . . . .

Blank cause of injury .......... 16.2 16.9 18.5 15.8 13.6 16.4 15.2 . . . . . . . . .

* Figure does not meet standard of reliability or precision. . . . Category not applicable. 1Includes other pedestrian and drowning.

Series 13, No. 131 [ Page 25
Table 9: Annual number, percent distribution, and rate of emergency department injury visits by intent, according to patient age, sex, and

race, averaged over a 4-year period: United States, 1992–95

Intent1 Total

Patient age Sex Race2

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits .............. 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Unintentional ............... 30,680 3,014 4,982 6,044 9,971 3,798 2,871 13,401 17,279 25,452 4,510

Intentional ................. 1,917 66 137 674 884 121 35 783 1,134 1,284 574

Self-inflicted . . . . . . . . . . . . . . 221 * * 76 118 * * 125 96 184 33

Assault ................. 1,669 65 123 592 749 109 32 652 1,017 1,087 530

Other violence . . . . . . . . . . . . . 27 * * * * * * * 21 * *

Undetermined intent . . . . . . . . . . 35 * * * * * * * 23 30 *

Missing cause .............. 4,154 418 413 682 1,480 621 539 2,044 2,110 3,231 824

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Unintentional ............... 83.4 86.1 90.0 81.6 80.8 83.6 83.3 82.5 84.1 84.8 76.3

Intentional . . . . . . . . . . . . . . . . . 5.2 1.9 2.5 9.1 7.2 2.7 1.0 4.8 5.5 4.3 9.7

Self-inflicted . . . . . . . . . . . . . . 0.6 * * 1.0 1.0 * * 0.8 0.5 0.6 0.6

Assault . . . . . . . . . . . . . . . . . 4.5 1.9 2.2 8.0 6.1 2.4 0.9 4.0 5.0 3.6 9.0

Other violence . . . . . . . . . . . . . 0.1 * * * * * * * 0.1 * *

Undetermined intent . . . . . . . . . . 0.1 * * * * * * * 0.1 0.1 *

Missing cause . . . . . . . . . . . . . . 11.3 11.9 7.5 9.2 12.0 13.7 15.6 12.6 10.3 10.8 13.9

Number of visits per 1,000 persons3

All injury visits .............. 143.2 174.3 145.6 210.1 150.2 90.7 110.7 123.2 164.4 140.8 181.9

Unintentional ............... 119.5 150.1 131.1 171.4 121.3 75.8 92.2 101.7 138.2 119.5 138.8

Intentional . . . . . . . . . . . . . . . . . 7.5 3.3 3.6 19.1 10.7 2.4 1.1 5.9 9.1 6.0 17.7

Self-inflicted . . . . . . . . . . . . . . 0.9 * * 2.2 1.4 * * 1.0 0.8 0.9 1.0

Assault . . . . . . . . . . . . . . . . . 6.5 3.2 3.2 16.8 9.1 2.2 1.0 4.9 8.1 5.1 16.3

Other violence . . . . . . . . . . . . . 0.1 * * * * * * * 0.2 * *

Undetermined intent . . . . . . . . . . 0.1 * * * * * * * 0.2 0.1 *

Missing cause .............. 16.2 20.8 10.9 19.4 18.0 12.4 17.3 15.5 16.9 15.2 25.4

* Figure does not meet standard of reliability or precision.

1Figures for intentional injuries may be underestimated due to underreporting.

2Estimates for races other than white and black have been omitted because of small sample sizes.

3Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

Page 26 [ Series 13, No. 131
Table 10: Annual number, percent distribution, and rate of emergency department injury visits by intent, according to hospital

characteristics, averaged over a 4-year period: United States, 1992–95

Intent1 Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits .............. 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Unintentional ............... 30,680 6,487 8,708 9,572 5,913 23,725 6,955 21,080 3,123 6,477

Intentional ................. 1,917 365 557 598 396 1,644 273 1,235 318 364

Self-inflicted . . . . . . . . . . . . . . 221 41 62 62 56 181 * 145 33 43

Assault ................. 1,669 319 492 526 332 1,439 231 1,074 278 317

Other violence . . . . . . . . . . . . . 27 * * * * 25 * * * *

Undetermined intent . . . . . . . . . . 35 * * * * 30 * 23 * *

Missing cause .............. 4,154 855 1,150 1,383 765 3,324 829 2,771 567 815

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Unintentional ............... 83.4 84.1 83.5 82.8 83.5 82.6 86.3 84.0 77.9 84.5

Intentional . . . . . . . . . . . . . . . . . 5.2 4.7 5.3 5.2 5.6 5.7 3.4 4.9 7.9 4.8

Self-inflicted . . . . . . . . . . . . . . 0.6 0.5 0.6 0.5 0.8 0.6 * 0.6 0.8 0.6

Assault . . . . . . . . . . . . . . . . . 4.5 4.1 4.7 4.5 4.7 5.0 2.9 4.3 6.9 4.1

Other violence . . . . . . . . . . . . . 0.1 * * * * 0.1 * * * *

Undetermined intent . . . . . . . . . . 0.1 * * * * 0.1 * 0.1 * *

Missing cause . . . . . . . . . . . . . . 11.3 11.1 11.0 12.0 10.8 11.6 10.3 11.0 14.1 10.6

Number of visits per 1,000 persons2

All injury visits .............. 143.2 152.7 167.5 132.1 125.4 142.1 147.6 . . . . . . . . .

Unintentional ............... 119.5 128.4 139.9 109.3 104.7 117.3 127.3 . . . . . . . . .

Intentional . . . . . . . . . . . . . . . . . 7.5 7.2 9.0 6.8 7.0 8.1 5.0 . . . . . . . . .

Self-inflicted . . . . . . . . . . . . . . 0.9 0.8 1.0 0.7 1.0 0.9 * . . . . . . . . .

Assault . . . . . . . . . . . . . . . . . 6.5 6.3 7.9 6.0 5.9 7.1 4.2 . . . . . . . . .

Other violence . . . . . . . . . . . . . 0.1 * * * * 0.1 * . . . . . . . . .

Undetermined intent . . . . . . . . . . 0.1 * * * * 0.1 * . . . . . . . . .

Missing cause .............. 16.2 16.9 18.5 15.8 13.6 16.4 15.2 . . . . . . . . .

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

1Figures for intentional injuries may be underestimated due to underreporting.

2Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

Series 13, No. 131 [ Page 27
Table 11: Annual number of visits, percent distribution, and rate of emergency department injury visits by intent and mechanism of external

cause, averaged over a 4-year period: United States, 1992–95

Intent and mechanism

Number of

visits in

thousands

Percent

distribution

Number of

visits per

1,000 persons1

All injury visits ............................... 36,785 100.0 143.2

Unintentional ................................ 30,680 83.4 119.5

Falls .................................... 7,839 21.3 30.5

Struck by/against ............................ 3,658 9.9 14.2

Motor vehicle traffic .......................... 3,956 10.8 15.4

Cut/pierce ................................ 2,962 8.1 11.5

Overexertion ............................... 1,597 4.3 6.2

Natural/environmental ......................... 1,503 4.1 5.9

Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 731 2.0 2.8

Fire/burn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 593 1.6 2.3

Pedal cycle, nontraffic . . . . . . . . . . . . . . . . . . . . . . . . . 493 1.3 1.9

Machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314 0.9 1.2

Transportation, other . . . . . . . . . . . . . . . . . . . . . . . . . . 287 0.8 1.1

Suffocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 0.2 0.3

Firearm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 0.3 0.5

Other mechanism ............................ 1,947 5.3 7.6

Not elsewhere classified . . . . . . . . . . . . . . . . . . . . . . . 298 0.8 1.2

Mechanism not specified ....................... 4,291 11.7 16.7

Intentional2 ................................. 1,917 5.2 7.5

Self-inflicted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 0.6 0.9

Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 0.3 0.5

Cut/pierce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 0.2 0.2

Other mechanism . . . . . . . . . . . . . . . . . . . . . . . . . . 35 0.1 0.1

Not elsewhere classified ...................... * * *

Mechanism not specified ...................... * * *

Assault .................................. 1,669 4.5 6.5

Struck by/against . . . . . . . . . . . . . . . . . . . . . . . . . . 680 1.8 2.6

Cut/pierce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 0.4 0.6

Other mechanism . . . . . . . . . . . . . . . . . . . . . . . . . . 148 0.4 0.6

Not elsewhere classified . . . . . . . . . . . . . . . . . . . . . . 126 0.3 0.5

Mechanism not specified . . . . . . . . . . . . . . . . . . . . . . 550 1.5 2.1

Other violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 0.1 0.1

Undetermined intent . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 0.1 0.1

Missing cause ............................... 4,154 11.3 16.2

* Figure does not meet standard of reliability or precision.

1Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

2Figures for intentional injuries may be underestimated due to underreporting.

Page 28 [ Series 13, No. 131
Table 12. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent external causes of

injury, according to patient’s age, sex, and race, averaged over a 4-year period: United States, 1992–95

External cause of injury and

3-digit ICD–9–CM E–code1 Total

Patient age Sex Race2

Under 5

years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury-related visits ................... 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Other and unspecified falls ............ E888 4,096 608 737 432 780 470 1,070 2,204 1,892 3,540 483

Striking against or struck by objects

or persons ...................... E917 3,217 330 767 750 970 294 106 1,112 2,105 2,702 448

Cutting or piercing instruments .......... E920 2,962 162 482 644 1,185 367 123 973 1,990 2,448 412

Unspecified motor vehicle traffic ......... E819 2,720 107 212 811 1,080 363 147 1,400 1,320 2,092 557

Overexertion ..................... E927 1,597 49 103 364 790 229 62 671 926 1,367 211

Other and unspecified causes .......... E928 1,457 92 317 406 467 114 60 495 962 1,226 205

Fall on same level .................. E885 1,394 70 189 198 432 258 247 768 626 1,213 142

Other fall from one level to another ....... E884 1,146 308 305 89 161 106 178 508 638 983 131

Other injury caused by animals .......... E906 918 137 238 131 237 106 69 444 473 781 124

Unspecified assault ................. E968 778 * 29 277 378 59 * 322 457 499 253

Caught in or between objects ........... E918 699 101 122 131 219 98 28 303 396 587 97

Fall from stairs .................... E880 698 91 81 115 218 111 82 428 269 572 110

Fight, brawl, rape—homicidal ........... E960 657 * 69 244 282 33 * 270 387 459 176

Foreign body accidentally entering eye

and adnexa ..................... E914 604 26 37 116 324 91 * 157 447 539 55

Other motor vehicle accident involving

collision with another motor vehicle ...... E812 588 * 38 157 253 75 47 309 280 450 115

Pedal cycle accident ................ E826 508 56 288 72 68 * * 158 351 444 54

Venomous animals and plants .......... E905 476 51 85 81 166 59 34 208 268 413 57

Struck by falling object ............... E916 441 39 33 92 194 64 * 155 286 370 60

Other motor vehicle nontraffic accident ..... E824 429 90 38 92 151 45 * 190 239 331 88

Foreign body accidentally entering an orifice . E915 320 106 68 30 65 30 22 158 162 238 73

All other causes ....................... 6,926 604 884 1,495 2,449 936 559 2,965 3,961 5,513 1,238

Missing cause ........................ 4,154 418 413 682 1,480 621 539 2,044 2,110 3,231 824

Percent distribution

All injury-related visits ................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Other and unspecified falls ............ E888 11.1 17.4 13.3 5.8 6.3 10.3 31.0 13.6 9.2 11.8 8.2

Striking against or struck by objects

or persons ...................... E917 8.7 9.4 13.9 10.1 7.9 6.5 3.1 6.8 10.2 9.0 7.6

Cutting or piercing instruments .......... E920 8.1 4.6 8.7 8.7 9.6 8.1 3.6 6.0 9.7 8.2 7.0

Unspecified motor vehicle accident ....... E819 7.4 3.1 3.8 10.9 8.7 8.0 4.3 8.6 6.4 7.0 9.4

Overexertion ..................... E927 4.3 1.4 1.9 4.9 6.4 5.0 1.8 4.1 4.5 4.6 3.6

Other and unspecified causes .......... E928 4.0 2.6 5.7 5.5 3.8 2.5 1.8 3.0 4.7 4.1 3.5

Fall on same level .................. E885 3.8 2.0 3.4 2.7 3.5 5.7 7.2 4.7 3.0 4.0 2.4

Other fall from one level to another ....... E884 3.1 8.8 5.5 1.2 1.3 2.3 5.2 3.1 3.1 3.3 2.2

Other injury caused by animals .......... E906 2.5 3.9 4.3 1.8 1.9 2.3 2.0 2.7 2.3 2.6 2.1

Unspecified assault ................. E968 2.1 * 0.5 3.7 3.1 1.3 * 2.0 2.2 1.7 4.3

Caught in or between objects ........... E918 1.9 2.9 2.2 1.8 1.8 2.2 0.8 1.9 1.9 2.0 1.6

Fall from stairs .................... E880 1.9 2.6 1.5 1.6 1.8 2.4 2.4 2.6 1.3 1.9 1.9

Fight, brawl, rape—homicidal ........... E960 1.8 * 1.2 3.3 2.3 0.7 * 1.7 1.9 1.5 3.0

Foreign body accidentally entering eye

and adnexa ..................... E914 1.6 0.7 0.7 1.6 2.6 2.0 * 1.0 2.2 1.8 0.9

Other motor vehicle accident involving

collision with another motor vehicle ...... E812 1.6 * 0.7 2.1 2.1 1.6 1.4 1.9 1.4 1.5 1.9

Pedal cycle accident ................ E826 1.4 1.6 5.2 1.0 0.5 * * 1.0 1.7 1.5 0.9

Venomous animals and plants .......... E905 1.3 1.5 1.5 1.1 1.3 1.3 1.0 1.3 1.3 1.4 1.0

Struck by falling object ............... E916 1.2 1.1 0.6 1.2 1.6 1.4 * 1.0 1.4 1.2 1.0

Other motor vehicle nontraffic accident ..... E824 1.2 2.6 0.7 1.2 1.2 1.0 * 1.2 1.2 1.1 1.5

Foreign body accidentally entering an orifice . E915 0.9 3.0 1.2 0.4 0.5 0.7 0.6 1.0 0.8 0.8 1.2

All other causes ....................... 18.8 17.3 16.0 20.2 19.8 20.6 16.2 18.3 19.3 18.4 20.9

Missing cause . . . . . . . . . . . . . . . . . . . . . . . . 11.3 11.9 7.5 9.2 12.0 13.7 15.6 12.6 10.3 10.8 13.9

* Figure does not meet standard of reliability or precision.

1Based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9–CM) , ‘‘Supplementary Classification of External Causes of Injury and Poisoning’’ (8). 2Estimates for races other than white and black have been omitted because of small sample sizes.

Series 13, No. 131 [ Page 29
Table 13. Annual number and percent distribution of injury-related emergency department visits by the 20 most frequent external causes of

injury, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95

External cause of injury and

3-digit ICD–9–CM E–code1 Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury-related visits ................... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Other and unspecified falls ............ E888 4,096 822 1,182 1,391 701 3,105 991 2,812 383 901

Striking against or struck by objects

or persons ...................... E917 3,217 666 988 952 610 2,507 710 2,281 318 618

Cutting or piercing instruments .......... E920 2,962 643 825 867 628 2,283 680 2,018 282 662

Unspecified motor vehicle traffic ......... E819 2,720 564 676 1,072 409 2,249 471 1,826 288 606

Overexertion ..................... E927 1,597 343 479 457 319 1,256 341 1,135 132 330

Other and unspecified causes .......... E928 1,457 314 413 454 276 1,151 306 1,001 135 320

Fall on same level .................. E885 1,394 370 428 315 281 1,056 338 1,002 111 281

Other fall from one level to another ....... E884 1,146 214 326 356 249 860 285 804 110 231

Other injury caused by animals .......... E906 918 216 212 315 175 702 215 594 108 215

Unspecified assault ................. E968 778 152 236 226 164 675 103 490 143 146

Caught in or between objects ........... E918 699 161 212 195 131 517 182 504 54 142

Fall from stairs .................... E880 698 197 214 162 125 562 136 518 61 119

Fight, brawl, rape—homicidal ........... E960 657 121 186 219 131 556 101 438 95 124

Foreign body accidentally entering

eye and adnexa .................. E914 604 124 206 142 133 443 161 431 71 103

Other motor vehicle accident involving

collision with another motor vehicle ...... E812 588 106 191 168 123 489 99 429 60 99

Pedal cycle accident ................ E826 508 122 150 107 129 410 98 355 49 104

Venomous animals and plants .......... E905 476 114 136 162 63 344 132 321 55 100

Struck by falling object ............... E916 441 101 116 146 79 348 93 302 28 111

Other motor vehicle nontraffic accident ..... E824 429 80 139 139 71 347 82 294 50 85

Foreign body accidentally entering an orifice . E915 320 75 60 119 66 257 63 205 39 76

All other causes ....................... 6,926 1,351 1,901 2,221 1,453 5,281 1,645 4,579 870 1,478

Missing cause ........................ 4,154 855 1,150 1,383 765 3,324 829 2,771 567 815

Percent distribution

All injury-related visits ................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Other and unspecified falls ............ E888 11.1 10.7 11.3 12.0 9.9 10.8 12.3 11.2 9.5 11.8

Striking against or struck by objects

or persons ...................... E917 8.7 8.6 9.5 8.2 8.6 8.7 8.8 9.1 7.9 8.1

Cutting or piercing instruments .......... E920 8.1 8.3 7.9 7.5 8.9 7.9 8.4 8.0 7.0 8.6

Unspecified motor vehicle accident ....... E819 7.4 7.3 6.5 9.3 5.8 7.8 5.8 7.3 7.2 7.9

Overexertion ..................... E927 4.3 4.4 4.6 3.9 4.5 4.4 4.2 4.5 3.3 4.3

Other and unspecified causes .......... E928 4.0 4.1 4.0 3.9 3.9 4.0 3.8 4.0 3.4 4.2

Fall on same level .................. E885 3.8 4.8 4.1 2.7 4.0 3.7 4.2 4.0 2.8 3.7

Other fall from one level to another ....... E884 3.1 2.8 3.1 3.1 3.5 3.0 3.5 3.2 2.8 3.0

Other injury caused by animals .......... E906 2.5 2.8 2.0 2.7 2.5 2.4 2.7 2.4 2.7 2.8

Unspecified assault ................. E968 2.1 2.0 2.3 2.0 2.3 2.4 1.3 2.0 3.6 1.9

Caught in or between objects ........... E918 1.9 2.1 2.0 1.7 1.8 1.8 2.3 2.0 1.3 1.8

Fall from stairs .................... E880 1.9 2.6 2.0 1.4 1.8 2.0 1.7 2.1 1.5 1.6

Fight, brawl, rape—homicidal ........... E960 1.8 1.6 1.8 1.9 1.8 1.9 1.2 1.7 2.4 1.6

Foreign body accidentally entering

eye and adnexa .................. E914 1.6 1.6 2.0 1.2 1.9 1.5 2.0 1.7 1.8 1.3

Other motor vehicle accident involving

collision with another motor vehicle ...... E812 1.6 1.4 1.8 1.5 1.7 1.7 1.2 1.7 1.5 1.3

Pedal cycle accident ................ E826 1.4 1.6 1.4 0.9 1.8 1.4 1.2 1.4 1.2 1.4

Venomous animals and plants .......... E905 1.3 1.5 1.3 1.4 0.9 1.2 1.6 1.3 1.4 1.3

Struck by falling object ............... E916 1.2 1.3 1.1 1.3 1.1 1.2 1.2 1.2 0.7 1.4

Other motor vehicle nontraffic accident ..... E824 1.2 1.0 1.3 1.2 1.0 1.2 1.0 1.2 1.2 1.1

Foreign body accidentally entering an orifice . E915 0.9 1.0 0.6 1.0 0.9 0.9 0.8 0.8 1.0 1.0

All other causes ....................... 18.8 17.5 18.2 19.2 20.5 18.4 20.4 18.2 21.7 19.3

Missing cause . . . . . . . . . . . . . . . . . . . . . . . . 11.3 11.1 11.0 12.0 10.8 11.6 10.3 11.0 14.1 10.6

1Based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9–CM), ‘‘Supplementary Classification of External Causes of Injury and Poisoning’’ (8).

Page 30 [ Series 13, No. 131
Table 14: Annual number and percent distribution of emergency department injury visits by principal diagnosis, according to patient age,

sex, and race, averaged over a 4-year period: United States, 1992–95

Principal diagnosis group Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits ....................... 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Illness diagnoses ..................... 5,580 437 454 875 2,058 893 863 2,754 2,826 4,387 1,075

Musculoskeletal system ................ 1,481 53 101 212 694 262 159 737 743 1,163 290

Symptoms and ill-defined conditions ........ 1,072 60 83 169 326 190 244 551 521 845 201

Skin and subcutaneous tissue . . . . . . . . . . . . 618 65 95 99 222 92 45 259 359 518 87

Mental disorders . . . . . . . . . . . . . . . . . . . . 559 * 30 106 264 94 55 239 320 443 101

Nervous system and sense organs . . . . . . . . . 477 94 55 73 173 55 27 209 268 379 86

Other illnesses ..................... 1,373 165 91 216 379 199 334 759 614 1,038 311

Injury and poisoning ................... 29,413 2,740 4,728 6,136 9,520 3,480 2,411 12,660 16,753 24,282 4,434

Fractures ......................... 3,808 203 822 534 984 537 729 1,750 2,057 3,343 381

Fracture of radius and ulna . . . . . . . . . . . . 581 48 271 52 77 60 73 281 300 515 48

Fracture of hand and fingers . . . . . . . . . . . 885 24 221 207 257 95 81 307 578 781 89

Fracture of lower limb ................ 1,277 52 147 143 364 235 336 665 612 1,100 149

Other fractures .................... 1,065 79 184 131 285 147 238 497 568 947 95

Sprains and strains ................... 5,712 27 659 1,502 2,271 727 255 2,734 2,978 4,683 908

Sprains and strains of wrist and hand . . . . . . 572 * 154 154 190 41 * 235 337 498 65

Sprains and strains of knee and leg . . . . . . . 527 * 65 135 223 68 31 227 300 450 70

Sprains and strains of ankle ............ 1,159 * 205 379 422 103 32 550 609 1,007 138

Sprains and strains of neck ............ 1,063 * 66 300 504 143 41 575 488 821 209

Other sprains and strains of back ........ 1,223 * 27 251 655 216 68 556 666 990 209

Other sprains and strains ............. 1,168 27 142 283 277 157 82 590 578 918 216

Open wounds ...................... 8,085 1,102 1,536 1,601 2,454 862 530 2,678 5,407 6,606 1,257

Open wound of head ................ 2,910 764 666 446 592 228 215 952 1,958 2,388 444

Open wound of hand and fingers ......... 2,178 93 205 526 937 299 118 678 1,499 1,832 295

Other open wound .................. 2,997 246 666 629 926 335 197 1,048 1,950 2,386 519

Superficial injuries ................... 6,442 539 1,125 1,457 2,051 733 522 3,071 3,370 5,285 1,015

Superficial injury of cornea . . . . . . . . . . . . . 452 31 45 72 226 61 * 190 262 388 57

Other superficial injury . . . . . . . . . . . . . . . 1,110 122 239 225 321 121 82 436 674 894 196

Contusions with intact skin surfaces ....... 4,880 386 841 1,159 1,503 550 440 2,445 2,435 4,003 761

Other injuries ...................... 5,367 870 587 1,043 1,760 622 375 2,427 2,940 4,365 873

Intracranial injury, excluding those with

skull fractures . . . . . . . . . . . . . . . . . . . . 847 184 167 160 207 68 59 314 532 691 130

Foreign body . . . . . . . . . . . . . . . . . . . . . 661 138 89 98 215 90 31 232 430 556 82

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . 655 114 55 141 238 84 * 259 396 511 129

Other injuries ..................... 1,369 167 93 305 455 156 104 578 791 1,127 221

Poisonings . . . . . . . . . . . . . . . . . . . . . . 953 184 98 204 325 90 52 515 439 789 141

Other and unspecified effects of external

causes . . . . . . . . . . . . . . . . . . . . . . . . 691 83 83 113 258 103 52 435 256 528 146

Complications of surgical and medical care,

NEC2 . . . . . . . . . . . . . . . . . . . . . . . . . . 191 * * 22 62 33 55 95 97 163 24

Supplementary classification of factors influencing

health status and contact with health services . . . 1,115 161 167 251 351 101 85 507 608 855 222

Unknown and blank . . . . . . . . . . . . . . . . . . . . 676 100 85 148 218 72 53 318 359 474 180

See footnotes at end of table.

Series 13, No. 131 [ Page 31
Table 14: Annual number and percent distribution of emergency department injury visits by principal diagnosis, according to patient age,

sex, and race, averaged over a 4-year period: United States, 1992–95—Con.

Principal diagnosis group Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Percent distribution

All injury visits ....................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Illness diagnoses ..................... 15.2 12.5 8.2 11.8 16.7 19.6 25.0 17.0 13.8 14.6 18.2

Musculoskeletal system . . . . . . . . . . . . . . . . 4.0 1.5 1.8 2.9 5.6 5.8 4.6 4.5 3.6 3.9 4.9

Symptoms and ill-defined conditions . . . . . . . . 2.9 1.7 1.5 2.3 2.6 4.2 7.1 3.4 2.5 2.8 3.4

Skin and subcutaneous tissue . . . . . . . . . . . . 1.7 1.9 1.7 1.3 1.8 2.0 1.3 1.6 1.7 1.7 1.5

Mental disorders . . . . . . . . . . . . . . . . . . . . 1.5 * 0.5 1.4 2.1 2.1 1.6 1.5 1.6 1.5 1.7

Nervous system and sense organs . . . . . . . . . 1.3 2.7 1.0 1.0 1.4 1.2 0.8 1.3 1.3 1.3 1.5

Other illnesses . . . . . . . . . . . . . . . . . . . . . 3.7 4.7 1.6 2.9 3.1 4.4 9.7 4.7 3.0 3.5 5.3

Injury and poisoning ................... 80.0 78.3 85.4 82.8 77.1 76.5 69.9 78.0 81.5 80.9 75.0

Fractures ......................... 10.4 5.8 14.8 7.2 8.0 11.8 21.1 10.8 10.0 11.1 6.4

Fracture of radius and ulna . . . . . . . . . . . . 1.6 1.4 4.9 0.7 0.6 1.3 2.1 1.7 1.5 1.7 0.8

Fracture of hand and fingers . . . . . . . . . . . 2.4 0.7 4.0 2.8 2.1 2.1 2.4 1.9 2.8 2.6 1.5

Fracture of lower limb . . . . . . . . . . . . . . . . 3.5 1.5 2.7 1.9 2.9 5.2 9.7 4.1 3.0 3.7 2.5

Other fractures . . . . . . . . . . . . . . . . . . . . 2.9 2.3 3.3 1.8 2.3 3.2 6.9 3.1 2.8 3.2 1.6

Sprains and strains ................... 15.5 0.8 11.9 20.3 18.4 16.0 7.4 16.8 14.5 15.6 15.4

Sprains and strains of wrist and hand . . . . . . 1.6 * 2.8 2.1 1.5 0.9 * 1.5 1.6 1.7 1.1

Sprains and strains of knee and leg . . . . . . . 1.4 * 1.2 1.8 1.8 1.5 0.9 1.4 1.5 1.5 1.2

Sprains and strains of ankle . . . . . . . . . . . . 3.2 * 3.7 5.1 3.4 2.3 0.9 3.4 3.0 3.4 2.3

Sprains and strains of neck . . . . . . . . . . . . 2.9 * 1.2 4.0 4.1 3.1 1.2 3.5 2.4 2.7 3.5

Other sprains and strains of back . . . . . . . . 3.3 * 0.5 3.4 5.3 4.7 2.0 3.4 3.2 3.3 3.5

Other sprains and strains . . . . . . . . . . . . . 3.2 0.8 2.6 3.8 2.2 3.5 2.4 3.6 2.8 3.1 3.7

Open wounds ...................... 22.0 31.5 27.8 21.6 19.9 19.0 15.4 16.5 26.3 22.0 21.3

Open wound of head . . . . . . . . . . . . . . . . 7.9 21.8 12.0 6.0 4.8 5.0 6.2 5.9 9.5 8.0 7.5

Open wound of hand and fingers . . . . . . . . . 5.9 2.7 3.7 7.1 7.6 6.6 3.4 4.2 7.3 6.1 5.0

Other open wound . . . . . . . . . . . . . . . . . . 8.1 7.0 12.0 8.5 7.5 7.4 5.7 6.5 9.5 8.0 8.8

Superficial injuries ................... 17.5 15.4 20.3 19.7 16.6 16.1 15.1 18.9 16.4 17.6 17.2

Superficial injury of cornea . . . . . . . . . . . . . 1.2 0.9 0.8 1.0 1.8 1.3 * 1.2 1.3 1.3 1.0

Other superficial injury . . . . . . . . . . . . . . . 3.0 3.5 4.3 3.0 2.6 2.7 2.4 2.7 3.3 3.0 3.3

Contusions with intact skin surfaces ....... 13.3 11.0 15.2 15.6 12.2 12.1 12.8 15.1 11.9 13.3 12.9

Other injuries ...................... 14.6 24.9 10.6 14.1 14.3 13.7 10.9 14.9 14.3 14.6 14.8

Intracranial injury, excluding those with skull

fractures . . . . . . . . . . . . . . . . . . . . . . . 2.3 5.3 3.0 2.2 1.7 1.5 1.7 1.9 2.6 2.3 2.2

Foreign body . . . . . . . . . . . . . . . . . . . . . 1.8 3.9 1.6 1.3 1.7 2.0 0.9 1.4 2.1 1.9 1.4

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8 3.3 1.0 1.9 1.9 1.8 * 1.6 1.9 1.7 2.2

Other injuries . . . . . . . . . . . . . . . . . . . . . 3.7 4.8 1.7 4.1 3.7 3.4 3.0 3.6 3.9 3.8 3.7

Poisonings . . . . . . . . . . . . . . . . . . . . . . 2.6 5.3 1.8 2.7 2.6 2.0 1.5 3.2 2.1 2.6 2.4

Other and unspecified effects of external

causes . . . . . . . . . . . . . . . . . . . . . . . . 1.9 2.4 1.5 1.5 2.1 2.3 1.5 2.7 1.2 1.8 2.5

Complications of surgical and medical care,

NEC2 . . . . . . . . . . . . . . . . . . . . . . . . . 0.5 * * 0.3 0.5 0.7 1.6 0.6 0.5 0.5 0.4

Supplementary classification of factors influencing

health status and contact with health services . . . 3.0 4.6 3.0 3.4 2.8 2.2 2.5 3.1 3.0 2.8 3.8

Unknown and blank . . . . . . . . . . . . . . . . . . . . 1.8 2.8 1.5 2.0 1.8 1.6 1.5 2.0 1.7 1.6 3.1

* Figure does not meet standard of reliability or precision.

1Estimates for races other than white and black have been omitted because of small sample sizes.

2NEC is not elsewhere classified.

Page 32 [ Series 13, No. 131
Table 15. Annual rate of emergency department injury visits by principal diagnosis, according to patient age, sex, and race, averaged over a

4-year period: United States, 1992–95

Principal diagnosis group Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits per 1,000 persons

All injury visits ....................... 143.2 174.3 145.6 210.1 150.2 90.7 110.7 123.2 164.4 140.8 181.9

Illness diagnoses ..................... 21.7 21.8 11.9 24.8 25.0 17.8 27.7 20.9 22.6 20.6 33.1

Musculoskeletal system . . . . . . . . . . . . . . . . 5.8 2.6 2.7 6.0 8.4 5.2 5.1 5.6 5.9 5.5 8.9

Symptoms and ill-defined conditions . . . . . . . . 4.2 3.0 2.2 4.8 4.0 3.8 7.8 4.2 4.2 4.0 6.2

Skin and subcutaneous tissue . . . . . . . . . . . . 2.4 3.3 2.5 2.8 2.7 1.8 1.4 2.0 2.9 2.4 2.7

Mental disorders . . . . . . . . . . . . . . . . . . . . 2.2 * 0.8 3.0 3.2 1.9 1.8 1.8 2.6 2.1 3.1

Nervous system and sense organs . . . . . . . . . 1.9 4.7 1.4 2.1 2.1 1.1 0.9 1.6 2.1 1.8 2.6

Other illnesses . . . . . . . . . . . . . . . . . . . . . 5.3 8.2 2.4 6.1 4.6 4.0 10.7 5.8 4.9 4.9 9.6

Injury and poisoning ................... 114.5 136.5 124.4 174.0 115.8 69.5 77.4 96.0 134.0 114.0 136.4

Fractures ......................... 14.8 10.1 21.6 15.1 12.0 10.7 23.4 13.3 16.5 15.7 11.7

Fracture of radius and ulna . . . . . . . . . . . . 2.3 2.4 7.1 1.5 0.9 1.2 2.3 2.1 2.4 2.4 1.5

Fracture of hand and fingers . . . . . . . . . . . 3.4 1.2 5.8 5.9 3.1 1.9 2.6 2.3 4.6 3.7 2.7

Fracture of lower limb . . . . . . . . . . . . . . . . 5.0 2.6 3.9 4.1 4.4 4.7 10.8 5.0 4.9 5.2 4.6

Other fractures . . . . . . . . . . . . . . . . . . . . 4.1 4.0 4.8 3.7 3.5 2.9 7.7 3.8 4.5 4.4 2.9

Sprains and strains ................... 22.2 1.4 17.3 42.6 27.6 14.5 8.2 20.7 23.8 22.0 27.9

Sprains and strains of wrist and hand . . . . . . 2.2 * 4.1 4.4 2.3 0.8 * 1.8 2.7 2.3 2.0

Sprains and strains of knee and leg . . . . . . . 2.1 * 1.7 3.8 2.7 1.4 1.0 1.7 2.4 2.1 2.2

Sprains and strains of ankle . . . . . . . . . . . . 4.5 * 5.4 10.8 5.1 2.0 1.0 4.2 4.9 4.7 4.2

Sprains and strains of neck . . . . . . . . . . . . 4.1 * 1.7 8.5 6.1 2.9 1.3 4.4 3.9 3.9 6.4

Other sprains and strains of back . . . . . . . . 4.8 * 0.7 7.1 8.0 4.3 2.2 4.2 5.3 4.6 6.4

Other sprains and strains . . . . . . . . . . . . . 4.5 1.4 3.7 8.0 3.4 3.1 2.6 4.5 4.6 4.3 6.6

Open wounds ...................... 31.5 54.9 40.4 45.4 29.8 17.2 17.0 20.3 43.3 31.0 38.7

Open wound of head . . . . . . . . . . . . . . . . 11.3 38.0 17.5 12.7 7.2 4.5 6.9 7.2 15.7 11.2 13.7

Open wound of hand and fingers . . . . . . . . . 8.5 4.6 5.4 14.9 11.4 6.0 3.8 5.1 12.0 8.6 9.1

Other open wound . . . . . . . . . . . . . . . . . . 11.7 12.2 17.5 17.8 11.3 6.7 6.3 7.9 15.6 11.2 16.0

Superficial injuries ................... 25.1 26.8 29.6 41.3 24.9 14.6 16.7 23.3 27.0 24.8 31.2

Superficial injury of cornea . . . . . . . . . . . . . 1.8 1.6 1.2 2.1 2.8 1.2 * 1.4 2.1 1.8 1.8

Other superficial injury . . . . . . . . . . . . . . . 4.3 6.1 6.3 6.4 3.9 2.4 2.6 3.3 5.4 4.2 6.0

Contusions with intact skin surfaces ....... 19.0 19.2 22.1 32.9 18.3 11.0 14.1 18.5 19.5 18.8 23.4

Other injuries ...................... 20.9 43.3 15.4 29.6 21.4 12.4 12.1 18.4 23.5 20.5 26.9

Intracranial injury, excluding those with skull

fractures . . . . . . . . . . . . . . . . . . . . . . . 3.3 9.2 4.4 4.6 2.5 1.4 1.9 2.4 4.3 3.2 4.0

Foreign body . . . . . . . . . . . . . . . . . . . . . 2.6 6.9 2.4 2.8 2.6 1.8 1.0 1.8 3.4 2.6 2.5

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 5.7 1.5 4.0 2.9 1.7 * 2.0 3.2 2.4 4.0

Other injuries . . . . . . . . . . . . . . . . . . . . . 5.3 8.3 2.4 8.7 5.5 3.1 3.3 4.4 6.3 5.3 6.8

Poisonings . . . . . . . . . . . . . . . . . . . . . . 3.7 9.2 2.6 5.8 4.0 1.8 1.7 3.9 3.5 3.7 4.3

Other and unspecified effects of external

causes . . . . . . . . . . . . . . . . . . . . . . . . 2.7 4.1 2.2 3.2 3.1 2.0 1.7 3.3 2.0 2.5 4.5

Complications of surgical and medical care,

NEC2 . . . . . . . . . . . . . . . . . . . . . . . . . 0.7 * * 0.6 0.7 0.7 1.8 0.7 0.8 0.8 0.7

Supplementary classification of factors influencing

health status and contact with health services 4.3 8.0 4.4 7.1 4.3 2.0 2.7 3.8 4.9 4.0 6.8

Unknown and blank . . . . . . . . . . . . . . . . . . . . 2.6 5.0 2.2 4.2 2.7 1.4 1.7 2.4 2.9 2.2 5.6

* Figure does not meet standard of reliability or precision.

1Estimates for races other white and black have been omitted because of small sample sizes.

2NEC is not elsewhere classified.

Series 13, No. 131 [ Page 33
nt distribution of emergency department injury visits by principal diagnosis, according to patient sex and age, averaged over a 4-year period:

Total

Female Male

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Number of visits in thousands

...... 36,785 1,515 2,233 2,914 5,087 2,243 2,247 1,984 3,302 4,495 7,260 2,304 1,201

...... 5,580 203 207 417 946 445 537 234 248 458 1,112 448 326

...... 1,481 28 44 100 319 133 114 25 57 112 375 130 45

...... 1,072 25 43 80 163 91 149 36 40 88 164 98 95

. . . . . . 618 23 31 41 86 50 27 42 64 58 135 42 *

. . . . . . 559 * * 43 101 43 31 * 14 63 163 51 24

. . . . . . 477 49 23 25 71 23 * 46 32 48 102 32 *

...... 1,373 74 50 127 206 105 198 81 40 89 174 95 135

...... 21,726 860 1,411 1,458 2,555 1,158 1,177 1,503 2,483 2,858 4,379 1,324 648

...... 3,808 89 305 152 369 265 570 114 517 381 615 272 158

. . . . . . 581 * 96 * 36 39 63 * 175 30 41 22 *

. . . . . . 885 * 76 42 83 39 59 * 145 165 174 56 23

...... 1,277 * 66 38 159 115 271 37 81 105 205 120 65

...... 1,065 39 67 50 91 73 178 40 117 81 195 75 61

...... 5,712 33 320 667 1,137 406 171 46 339 835 1,334 321 104

. . . . . . 572 * 65 57 78 20 * * 89 98 112 21 *

. . . . . . 527 * 34 48 86 35 * * 31 87 137 33 *

...... 1,159 * 111 155 189 60 29 * 95 225 233 43 *

...... 1,063 * 27 168 278 82 * * 39 132 226 61 *

...... 1,223 * * 101 284 122 35 * * 150 371 94 33

...... 1,168 * 72 139 222 87 56 * 70 144 254 70 26

...... 7,998 388 518 425 739 337 270 714 1,018 1,175 1,716 524 260

...... 2,910 258 199 125 159 89 121 506 466 321 432 138 95

...... 2,910 37 73 120 291 115 42 56 131 406 646 185 76

...... 2,178 93 245 180 289 133 107 152 421 449 637 201 89

...... 2,014 256 484 646 912 389 384 282 641 811 1,139 344 153

. . . . . . 452 * * 25 95 27 * 14 27 47 132 34 *

. . . . . . 452 53 85 84 123 55 36 68 154 141 199 66 46

. . . . . . 1,110 186 380 537 694 307 340 200 461 622 809 243 100

...... 5,367 420 299 414 744 320 229 459 389 629 1,016 302 146

skull

. . . . . . 847 75 50 62 57 33 36 109 117 98 150 34 23

. . . . . . 661 77 42 26 49 21 * 61 48 71 166 68 *

. . . . . . 655 48 * 48 89 37 * 66 35 92 150 46 *

...... 1,369 83 72 92 172 89 70 84 111 213 283 67 34

. . . . . . 953 91 62 101 173 61 28 93 37 103 152 29 *

al

. . . . . . 691 44 48 74 170 64 36 39 35 40 88 38 *

. . . . . . 191 * * * 36 * 27 * * * 26 * 28

encing

ces . . . . 1,115 82 64 133 136 39 54 79 103 119 215 62 31

. . . . . . 676 43 37 61 105 41 31 56 48 87 113 31 22

Page 34 [ Series 13, No. 131
nt distribution of emergency department injury visits by principal diagnosis, according to patient sex and age, averaged over a 4-year period:

Total

Female Male

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Percent distribution

...... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

...... 15.2 13.4 9.3 14.3 18.6 19.8 23.9 11.8 7.5 10.2 15.3 19.4 27.2

. . . . . . 4.0 1.8 2.0 3.4 6.3 5.9 5.1 1.3 1.7 2.5 5.2 5.6 3.8

. . . . . . 2.9 1.6 1.9 2.8 3.2 4.1 6.6 1.8 1.2 2.0 2.3 4.3 7.9

. . . . . . 1.7 1.5 1.4 1.4 1.7 2.2 1.2 2.1 1.9 1.3 1.9 1.8 *

. . . . . . 1.5 0.3 * * 2.0 1.9 1.4 * 0.4 1.4 2.2 2.2 2.0

. . . . . . 1.3 3.2 1.0 0.9 1.4 1.0 * 2.3 1.0 1.1 1.4 1.4 *

. . . . . . 3.7 4.9 2.2 4.4 4.1 4.7 8.8 4.1 1.2 2.0 2.4 4.1 11.3

...... 59.1 56.7 63.2 50.0 50.2 51.6 52.4 75.7 75.2 63.6 60.3 57.5 53.9

...... 10.4 5.9 13.7 5.2 7.2 11.8 25.4 5.7 15.7 8.5 8.5 11.8 13.2

. . . . . . 1.6 * 4.3 * 0.7 1.7 2.8 * 5.3 0.7 0.6 0.9 *. . . . . . 2.4 * 3.4 1.4 1.6 1.7 2.6 * 4.4 3.7 2.4 2.4 *

. . . . . . 3.5 * 3.0 1.3 3.1 5.1 12.1 1.9 2.4 2.3 2.8 5.2 5.4

. . . . . . 2.9 2.6 3.0 1.7 1.8 3.2 7.9 2.0 3.5 1.8 2.7 3.2 5.1

...... 15.5 2.2 14.3 22.9 22.4 18.1 7.6 2.3 10.3 18.6 18.4 13.9 8.6

. . . . . . 1.6 * 2.9 1.9 1.5 0.9 * * 2.7 2.2 1.5 0.9 *

. . . . . . 1.4 * 1.5 1.6 1.7 1.6 * * 0.9 1.9 1.9 1.4 *

. . . . . . 3.2 * 5.0 5.3 3.7 2.7 1.3 * 2.9 5.0 3.2 1.9 *

. . . . . . 2.9 * 1.2 5.7 5.5 3.7 * * 1.2 2.9 3.1 2.6 *

. . . . . . 3.3 * * 3.5 5.6 5.4 1.6 * * 3.3 5.1 4.1 2.8

. . . . . . 3.2 * 3.2 4.8 4.4 3.9 2.5 * 2.1 3.2 3.5 3.0 2.2

...... 21.7 25.6 23.2 14.6 14.5 15.0 12.0 36.0 30.8 26.1 23.6 22.8 21.7

. . . . . . 7.9 17.0 8.9 4.3 3.1 4.0 5.4 25.5 14.1 7.1 6.0 6.0 7.9

. . . . . . 7.9 2.5 3.3 4.1 5.7 5.1 1.9 2.8 4.0 9.0 8.9 8.0 6.3

. . . . . . 5.9 6.1 11.0 6.2 5.7 6.0 4.8 7.7 12.7 10.0 8.8 8.7 7.4

. . . . . . 5.5 16.9 21.7 22.2 17.9 17.3 17.1 14.2 19.4 18.0 15.7 14.9 12.8

. . . . . . 1.2 * * 0.9 1.9 1.2 * 0.7 0.8 1.0 1.8 1.5 *

. . . . . . 1.2 3.5 3.8 2.9 2.4 2.5 1.6 3.4 4.7 3.1 2.7 2.9 3.8

. . . . . . 3.0 12.3 17.0 18.4 13.6 13.7 15.1 10.1 14.0 13.8 11.1 10.6 8.3

...... 14.6 27.7 13.4 14.2 14.6 14.3 10.2 23.1 11.8 14.0 14.0 13.1 12.2

skull

. . . . . . 2.3 4.9 2.3 2.1 1.1 1.5 1.6 5.5 3.5 2.2 2.1 1.5 1.9

. . . . . . 1.8 5.1 1.9 0.9 1.0 0.9 * 3.1 1.4 1.6 2.3 3.0 *

. . . . . . 1.8 3.2 * 1.7 1.7 1.7 * 3.3 1.0 2.1 2.1 2.0 *

. . . . . . 3.7 5.5 3.2 3.2 3.4 4.0 3.1 4.2 3.4 4.7 3.9 2.9 2.8

. . . . . . 2.6 6.0 2.8 3.5 3.4 2.7 1.2 4.7 1.1 2.3 2.1 1.3 *

. . . . . . 1.9 2.9 2.2 2.5 3.3 2.9 1.6 2.0 1.1 0.9 1.2 1.7 *

. . . . . . 0.5 * * * 0.7 * 1.2 * * * 0.4 * 2.3

encing

ces . . . . 3.0 5.4 2.8 4.5 2.7 1.8 2.4 4.0 3.1 2.6 3.0 2.7 2.6

. . . . . . 1.8 2.8 1.7 2.1 2.1 1.8 1.4 2.8 1.5 1.9 1.6 1.3 1.9

cision.

Series 13, No. 131 [ Page 35
department injury visits by principal diagnosis, according to patient sex and age, averaged over a 4-year period: United States, 1992–95

Total

Female Male

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Number of visits per 1,000 persons

...... 143.2 154.5 120.4 165.2 121.8 86.4 124.0 193.1 169.8 255.1 179.4 95.4 7.0

...... 21.7 20.7 11.1 23.6 22.7 17.1 29.7 22.8 12.7 26.0 27.5 18.6 25.0

. . . . . . 5.8 2.8 2.4 5.7 7.6 5.1 6.3 2.4 2.9 6.3 9.3 5.4 3.5

. . . . . . 4.2 2.5 2.3 4.6 3.9 3.5 8.2 3.5 2.1 5.0 4.0 4.1 7.3

. . . . . . 2.4 2.3 1.7 2.3 2.0 1.9 1.5 4.1 3.3 3.3 3.3 1.8 *

. . . . . . 2.2 * * 2.4 2.4 1.7 1.7 * 0.7 3.6 4.0 2.1 1.8

. . . . . . 1.9 5.0 1.2 1.4 1.7 0.9 * 4.4 1.6 2.7 2.5 1.3 *

. . . . . . 5.3 7.5 2.7 7.2 4.9 4.0 11.0 7.9 2.1 5.1 4.3 3.9 10.4

...... 84.6 87.7 76.1 82.6 61.2 44.6 65.0 146.3 127.7 162.2 108.2 54.9 49.7

...... 14.8 9.1 16.4 8.6 8.8 10.2 31.5 11.1 26.6 21.6 15.2 11.3 12.2

. . . . . . 2.3 * 5.2 * 0.9 1.5 3.5 * 9.0 1.7 1.0 0.9 *

. . . . . . 3.4 * 4.1 2.4 2.0 1.5 3.2 * 7.4 9.4 4.3 2.3 *

. . . . . . 5.0 * 3.6 2.2 3.8 4.4 15.0 3.6 4.1 6.0 5.1 5.0 5.0

. . . . . . 4.1 4.0 3.6 2.9 2.2 2.8 9.8 3.9 6.0 4.6 4.8 3.1 4.7

...... 22.2 3.4 17.2 37.8 27.2 15.6 9.5 4.4 17.4 47.4 33.0 13.3 8.0

. . . . . . 2.2 * 3.5 3.2 1.9 0.8 * * 4.6 5.5 2.8 0.9 *

. . . . . . 2.1 * 1.9 2.7 2.1 1.4 * * 1.6 4.9 3.4 1.4 *

. . . . . . 4.5 * 6.0 8.8 4.5 2.3 1.6 * 4.9 12.8 5.8 1.8 *

. . . . . . 4.1 * 1.4 9.5 6.7 3.2 * * 2.0 7.5 5.6 2.5 *

. . . . . . 4.8 * * 5.7 6.8 4.7 1.9 * * 8.5 9.2 3.9 2.5

. . . . . . 4.5 * 3.9 7.9 5.3 3.3 3.1 * 3.6 8.1 6.3 2.9 2.0

...... 31.1 39.6 27.9 24.1 17.7 13.0 14.9 69.5 52.3 66.7 42.4 21.7 20.0

. . . . . . 11.3 26.3 10.7 7.1 3.8 3.4 6.7 49.2 24.0 18.2 10.7 5.7 7.3

. . . . . . 11.3 3.8 4.0 6.8 7.0 4.4 2.3 5.4 6.7 23.0 16.0 7.7 5.8

. . . . . . 8.5 9.5 13.2 10.2 6.9 5.1 5.9 14.8 21.6 25.5 15.7 8.3 6.9

. . . . . . 7.8 26.1 26.1 36.6 21.8 15.0 21.2 27.5 33.0 46.0 28.1 14.2 11.8

. . . . . . 1.8 * * 1.4 2.3 1.0 * * 1.4 2.7 3.3 1.4 *

. . . . . . 1.8 5.4 4.6 4.8 2.9 2.1 2.0 6.6 7.9 8.0 4.9 2.7 3.5

. . . . . . 4.3 19.0 20.5 30.4 16.6 11.8 18.8 19.4 23.7 35.3 20.0 10.1 7.7

...... 20.9 42.9 16.1 23.5 17.8 12.3 12.7 44.7 20.0 35.7 25.1 12.5 11.2

skull

. . . . . . 3.3 7.6 2.7 3.5 1.4 1.3 2.0 10.6 6.0 5.6 3.7 1.4 1.8

. . . . . . 2.6 7.9 2.2 1.5 1.2 0.8 * 5.9 2.5 4.0 4.1 2.8 *

. . . . . . 2.5 4.9 * 2.7 2.1 1.4 * 6.4 1.8 5.2 3.7 1.9 *

. . . . . . 5.3 8.5 3.9 5.2 4.1 3.4 3.9 8.1 5.7 12.1 7.0 2.8 2.6

. . . . . . 3.7 9.3 3.3 5.7 4.1 2.4 1.5 9.1 1.9 5.8 3.8 1.2 *

. . . . . . 2.7 4.5 2.6 4.2 4.1 2.5 2.0 3.8 1.8 2.2 2.2 1.6 *

. . . . . . 0.7 * * * 0.9 * 1.5 * * * 0.6 * 2.1

encing

ces 4.3 8.3 3.4 7.5 3.3 1.5 3.0 7.7 5.3 6.7 5.3 2.6 2.4

. . . . . . 2.6 4.4 2.0 3.4 2.5 1.6 1.7 5.5 2.5 5.0 2.8 1.3 1.7

cision.

Page 36 [ Series 13, No. 131
nt distribution of emergency department injury visits by principal diagnosis, according to patient race and age, averaged over a 4-year period:

Total

White Black

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Number of visits in thousands

...... 36,785 2,735 4,533 6,022 9,814 3,766 3,128 669 869 1,231 2,212 660 272

...... 5,580 314 358 675 1,563 704 773 115 91 184 441 165 80

...... 1,481 39 78 165 538 204 139 * * 44 145 54 17

...... 1,072 43 69 130 232 150 220 * * 36 85 28 21

. . . . . . 618 51 80 82 186 78 41 * * * 30 * *

. . . . . . 559 * 27 91 200 75 45 * * 13 55 19 *

. . . . . . 477 69 47 52 142 42 26 * * * 26 * *

...... 1,373 105 57 155 265 156 301 50 31 58 101 41 31

...... 21,726 2,236 3,892 5,053 7,841 2,925 2,235 494 720 951 1,630 462 178

...... 3,808 172 722 467 831 461 689 27 74 56 132 60 33

. . . . . . 581 42 245 48 60 49 71 * * * * * *

. . . . . . 885 20 188 181 233 80 79 * 30 * 21 * *

...... 1,277 43 121 124 299 198 315 * 18 * 57 30 *

...... 1,065 67 169 115 238 134 224 * * * 38 * *

...... 5,712 70 566 1,238 1,982 586 240 * 75 241 428 122 33

. . . . . . 572 * 139 140 158 35 * * * * 27 * *

. . . . . . 527 * 57 112 189 56 * * * * 31 * *

...... 1,159 * 182 315 371 93 30 * 21 62 45 * *

...... 1,063 * 56 239 370 109 38 * * 52 117 30 *

...... 1,223 * * 201 525 175 60 * * 46 117 34 *

...... 1,168 * 109 232 370 119 68 * 22 48 90 37 *

...... 7,998 893 1,157 1,273 1,970 741 472 178 242 284 415 95 43

...... 2,910 636 557 344 466 197 188 108 91 87 110 26 *

...... 2,910 67 66 447 783 263 106 * 37 67 132 27 *

...... 2,178 190 533 482 720 282 178 48 113 130 173 42 *

...... 2,014 431 916 1,200 1,636 611 492 98 184 227 367 102 38

. . . . . . 452 26 36 58 200 52 * * * * 24 * *

. . . . . . 452 92 184 183 255 104 76 28 51 35 62 * *

. . . . . . 1,110 313 695 959 1,181 456 400 65 126 180 281 78 32

...... 5,367 670 531 875 1,422 525 342 182 146 142 289 83 31

skull

. . . . . . 847 137 135 141 165 56 56 38 31 * 34 * *

. . . . . . 661 115 66 78 188 80 * * * * 23 * *

. . . . . . 655 75 40 120 181 74 * 35 * * 49 * *

...... 1,369 131 137 259 379 129 93 32 45 45 65 25 *

. . . . . . 953 144 81 173 266 78 46 37 * 25 50 * *

. . . . . . 691 59 62 87 198 77 45 22 * 22 51 * *

. . . . . . 191 * * * 44 30 52 * * * 15 * *

encing

ces 1,115 118 130 186 262 82 77 31 29 58 79 18 *

. . . . . . 676 67 52 108 148 56 43 28 29 38 63 15 *

Series 13, No. 131 [ Page 37
nt distribution of emergency department injury visits by principal diagnosis, according to patient race and age, averaged over a 4-year period:

Total

White Black

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Percent distribution

...... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

...... 15.2 11.5 7.9 11.2 15.9 18.7 24.7 17.3 10.4 14.9 19.9 25.0 29.2

. . . . . . 4.0 1.4 1.7 2.7 5.5 5.4 4.5 * * 3.6 6.5 8.2 6.4

. . . . . . 2.9 1.6 1.5 2.2 2.4 4.0 7.0 * * 2.9 3.8 4.3 7.8

. . . . . . 1.7 1.9 1.8 1.4 1.9 2.1 1.3 * * * 1.3 * *

. . . . . . 1.5 * 0.6 1.5 2.0 2.0 1.4 * * 1.1 2.5 2.9 *

. . . . . . 1.3 2.5 1.0 0.9 1.4 1.1 0.8 * * * 1.2 * *

. . . . . . 3.7 3.9 1.3 2.6 2.7 4.1 9.6 7.4 3.6 4.7 4.6 6.1 11.5

...... 59.1 81.8 85.9 83.9 79.9 77.7 71.4 73.8 82.9 77.2 73.7 70.0 65.5

...... 10.4 6.3 15.9 7.8 8.5 12.2 22.0 4.0 8.5 4.6 6.0 9.0 12.1

. . . . . . 1.6 1.5 5.4 0.8 0.6 1.3 2.3 * * * * * *

. . . . . . 2.4 0.7 4.1 3.0 2.4 2.1 2.5 * 3.4 * 1.0 * *

. . . . . . 3.5 1.6 2.7 2.1 3.1 5.3 10.1 * 2.1 * 2.6 4.6 *

. . . . . . 2.9 2.4 3.7 1.9 2.4 3.6 7.2 * * * 1.7 * *

...... 15.5 2.6 12.5 20.6 20.2 15.6 7.7 * 8.7 19.6 19.3 18.5 12.2

. . . . . . 1.6 * 3.1 2.3 1.6 0.9 * * * * 1.2 * *

. . . . . . 1.4 * 1.3 1.9 1.9 1.5 * * * * 1.4 * *

. . . . . . 3.2 * 4.0 5.2 3.8 2.5 1.0 * 2.4 5.1 2.1 * *

. . . . . . 2.9 * 1.2 4.0 3.8 2.9 1.2 * * 4.3 5.3 4.5 *

. . . . . . 3.3 * * 3.3 5.3 4.6 1.9 * * 3.7 5.3 5.2 *

. . . . . . 3.2 * 2.4 3.8 3.8 3.2 2.2 * 2.6 3.9 4.1 5.6 *

...... 21.7 32.7 25.5 21.1 20.1 19.7 15.1 26.6 27.8 23.1 18.8 14.4 15.8

. . . . . . 7.9 23.3 12.3 5.7 4.8 5.2 6.0 16.1 10.5 7.1 5.0 4.0 *

. . . . . . 7.9 2.5 1.5 7.4 8.0 7.0 3.4 * 4.3 5.4 6.0 4.2 *

. . . . . . 5.9 7.0 11.8 8.0 7.3 7.5 5.7 7.1 13.1 10.6 7.8 6.3 *

. . . . . . 5.5 15.7 20.2 19.9 16.7 16.2 15.7 14.6 21.2 18.4 16.6 15.5 13.8

. . . . . . 1.2 1.0 0.8 1.0 2.0 1.4 * * * * 1.1 * *

. . . . . . 1.2 3.3 4.1 3.0 2.6 2.8 2.4 4.2 5.9 2.8 2.8 * *

. . . . . . 3.0 11.4 15.3 15.9 12.0 12.1 12.8 9.7 14.5 14.6 12.7 11.8 11.8

...... 14.6 24.5 11.7 14.5 14.5 13.9 10.9 27.2 16.8 11.6 13.1 12.5 11.5

skull

. . . . . . 2.3 5.0 3.0 2.3 1.7 1.5 1.8 5.6 3.6 * 1.5 * *

. . . . . . 1.8 4.2 1.5 1.3 1.9 2.1 * * * * 1.0 * *

. . . . . . 1.8 2.7 0.9 2.0 1.8 2.0 * 5.3 * * 2.2 * *

. . . . . . 3.7 4.8 3.0 4.3 3.9 3.4 3.0 4.7 5.1 3.7 2.9 3.8 *

. . . . . . 2.6 5.3 1.8 2.9 2.7 2.1 1.5 5.6 * 2.0 2.3 * *

. . . . . . 1.9 2.2 1.4 1.4 2.0 2.1 1.4 3.3 * 1.8 2.3 * *

. . . . . . 0.5 * * * 0.5 0.8 1.7 * * * 0.7 * *

encing

ces 3.0 4.3 2.9 3.1 2.7 2.2 2.5 4.7 3.4 4.7 3.6 2.8 *

. . . . . . 1.8 2.5 1.2 1.8 1.5 1.5 1.4 4.2 3.3 3.1 2.9 2.2 *

cision.

Page 38 [ Series 13, No. 131
department injury visits by principal diagnosis, according to patient race and age, averaged over a 4-year period: United States, 1992–95

Total

White Black

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over

Number of visits per 1,000 persons

...... 143.2 173.0 150.3 214.5 144.2 87.5 112.3 203.5 144.0 233.3 217.7 128.2 104.7

...... 21.7 19.9 11.9 24.0 23.0 16.4 27.7 35.1 15.0 34.8 43.4 31.2 30.6

. . . . . . 5.8 2.5 2.6 5.9 7.9 4.7 5.0 * * 8.4 14.2 10.5 6.7

. . . . . . 4.2 2.7 2.3 4.6 3.4 3.5 7.9 * * 6.8 8.3 5.5 8.2

. . . . . . 2.4 3.2 2.7 2.9 2.7 1.8 1.5 * * * 2.9 * *

. . . . . . 2.2 * 0.9 3.2 2.9 1.7 1.6 * * 2.5 5.5 3.7 *

. . . . . . 1.9 4.4 1.6 1.9 2.1 1.0 0.9 * * * 2.5 * *

. . . . . . 5.3 6.7 1.9 5.5 3.9 3.6 10.8 15.1 5.1 10.9 9.9 7.9 12.0

...... 84.6 141.5 129.1 180.0 115.2 68.0 80.2 150.3 119.4 180.2 160.4 89.7 68.6

...... 14.8 10.9 24.0 16.6 12.2 10.7 24.7 8.2 12.2 10.6 13.0 11.6 12.7

. . . . . . 2.3 2.6 8.1 1.7 0.9 1.1 2.6 * * * * * *

. . . . . . 3.4 1.3 6.2 6.4 3.4 1.9 2.8 * 4.9 * 2.1 * *

. . . . . . 5.0 2.7 4.0 4.4 4.4 4.6 11.3 * 3.0 * 5.7 5.9 *

. . . . . . 4.1 4.2 5.6 4.1 3.5 3.1 8.1 * * * 3.8 * *

...... 22.2 4.4 18.8 44.1 29.1 13.6 8.6 * 12.5 45.7 42.1 23.7 12.8

. . . . . . 2.2 * 4.6 5.0 2.3 0.8 * * * 2.3 2.7 * *

. . . . . . 2.1 * 1.9 4.0 2.8 1.3 * * * 3.8 3.0 * *

. . . . . . 4.5 * 6.0 11.2 5.4 2.2 1.1 * 3.5 11.8 4.5 * *

. . . . . . 4.1 * 1.9 8.5 5.4 2.5 1.4 * * 9.9 11.5 5.8 *

. . . . . . 4.8 * * 7.2 7.7 4.1 2.2 * * 8.7 11.6 6.6 *

. . . . . . 4.5 * 3.6 8.2 5.4 2.8 2.4 * 3.7 9.1 8.8 7.2 *

...... 31.1 56.5 38.4 45.3 28.9 17.2 16.9 54.2 40.1 53.9 40.9 18.5 16.6

. . . . . . 11.3 40.2 18.5 12.2 6.8 4.6 6.8 32.8 15.1 16.5 10.8 5.1 *

. . . . . . 11.3 4.2 2.2 15.9 11.5 6.1 3.8 * 6.2 12.7 13.0 5.3 *

. . . . . . 8.5 12.0 17.7 17.2 10.6 6.5 6.4 14.5 18.8 24.7 17.1 8.1 *

. . . . . . 7.8 27.2 30.4 42.7 24.0 14.2 17.6 29.8 30.5 43.0 36.1 19.9 14.5

. . . . . . 1.8 1.6 1.2 2.1 2.9 1.2 * * * * 2.4 * *

. . . . . . 1.8 5.8 6.1 6.5 3.7 2.4 2.7 8.5 8.4 6.5 6.1 * *

. . . . . . 4.3 19.8 23.1 34.1 17.3 10.6 14.3 19.7 20.9 34.0 27.6 15.1 12.4

...... 20.9 42.4 17.6 31.2 20.9 12.2 12.3 55.4 24.1 27.0 28.4 16.1 12.1

skull

. . . . . . 3.3 8.7 4.5 5.0 2.4 1.3 2.0 11.5 5.1 * 3.4 * *

. . . . . . 2.6 7.3 2.2 2.8 2.8 1.9 * * * * 2.3 * *

. . . . . . 2.5 4.8 1.3 4.3 2.7 1.7 * 10.7 * * 4.9 * *

. . . . . . 5.3 8.3 4.6 9.2 5.6 3.0 3.3 9.6 7.4 8.6 6.4 4.8 *

. . . . . . 3.7 9.1 2.7 6.2 3.9 1.8 1.7 11.4 * 4.7 5.0 * *

. . . . . . 2.7 3.7 2.0 3.1 2.9 1.8 1.6 6.7 * 4.2 5.1 * *

. . . . . . 0.7 * * * 0.7 0.7 1.9 * * * 1.5 * *

encing

ces . . . . 4.3 7.4 4.3 6.6 3.8 1.9 2.8 9.6 4.9 11.1 7.7 3.6 *

. . . . . . 2.6 4.3 1.7 3.8 2.2 1.3 1.6 8.6 4.7 7.2 6.2 2.7 *

cision.

Series 13, No. 131 [ Page 39
nt distribution of emergency department injury visits by principal diagnosis, according to hospital characteristics, averaged over a 4-year

Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

Nonmetropolitan Voluntary, nonprofit Non-Federal government Proprietary

Number of visits in thousands

...... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

...... 5,580 1,070 1,547 1,903 1,060 4,374 1,206 3,767 729 1,083

...... 1,481 260 393 522 306 1,137 344 970 187 324

...... 1,072 162 311 379 220 831 241 712 153 207

. . . . . . 618 145 171 185 117 451 168 451 64 103

. . . . . . 559 146 145 145 123 460 99 376 89 94

. . . . . . 477 106 126 148 97 381 96 345 53 79

...... 1,373 251 402 524 197 1,115 258 913 184 277

...... 21,726 6,304 8,432 9,014 5,663 22,894 6,519 20,161 3,020 6,232

...... 3,808 822 1,139 1,113 734 2,901 907 2,625 372 810

. . . . . . 581 105 166 173 136 435 146 404 63 114

. . . . . . 885 203 292 232 158 682 203 618 79 188

...... 1,277 286 376 371 244 977 300 881 119 276

...... 1,065 227 305 337 196 808 257 722 111 233

...... 5,712 1,342 1,622 1,679 1,070 4,327 1,186 4,037 489 1,187

. . . . . . 572 159 172 139 102 432 140 418 44 111

. . . . . . 527 135 158 151 84 401 126 378 44 105

...... 1,159 267 373 320 199 884 275 807 114 238

...... 1,063 227 263 337 236 716 147 787 77 199

...... 1,223 270 318 378 257 979 243 827 100 296

...... 1,168 284 339 354 191 914 254 821 110 238

...... 7,998 1,712 2,272 2,489 1,611 6,325 1,760 5,458 848 1,778

...... 2,910 589 808 933 580 2,333 577 1,982 326 603

...... 2,910 446 682 621 428 1,690 488 1,505 218 455

...... 2,178 677 782 935 603 2,302 695 1,972 305 721

...... 2,014 1,386 1,799 2,063 1,193 5,231 1,510 4,444 643 1,354

. . . . . . 452 121 122 107 101 643 109 332 37 82

. . . . . . 452 277 277 352 204 838 272 723 136 251

. . . . . . 1,110 987 1,401 1,604 888 3,751 1,129 3,389 470 1,021

...... 5,367 1,042 1,600 1,669 1,055 4,209 1,157 3,597 667 1,103

skull

. . . . . . 847 164 263 233 187 701 146 578 103 166

. . . . . . 661 133 204 178 146 499 162 455 78 128

. . . . . . 655 124 205 212 114 529 126 455 74 126

...... 1,369 238 428 460 243 1,065 304 902 200 267

. . . . . . 953 169 303 294 188 722 231 620 113 220

. . . . . . 691 166 167 225 132 549 142 477 69 145

. . . . . . 191 49 31 68 44 145 47 110 30 51

encing

ces 1,115 218 293 373 232 921 194 735 170 210

. . . . . . 676 121 155 275 125 534 143 446 91 140

Page 40 [ Series 13, No. 131
nt distribution of emergency department injury visits by principal diagnosis, according to hospital characteristics, averaged over a 4-year

n.

Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

Nonmetropolitan Voluntary, nonprofit Non-Federal government Proprietary

Percent distribution

...... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

...... 15.2 13.9 14.8 16.5 15.0 15.2 15.0 15.0 18.2 14.1

. . . . . . 4.0 3.4 3.8 4.5 4.3 4.0 4.3 3.9 4.7 4.2

. . . . . . 2.9 2.1 3.0 3.3 3.1 2.9 3.0 2.8 3.8 2.7

. . . . . . 1.7 1.9 1.6 1.6 1.6 1.6 2.1 1.8 1.6 1.3

. . . . . . 1.5 1.9 1.4 1.3 1.7 1.6 1.2 1.5 2.2 1.2

. . . . . . 1.3 1.4 1.2 1.3 1.4 1.3 1.2 1.4 1.3 1.0

. . . . . . 3.7 3.3 3.9 4.5 2.8 3.9 3.2 3.6 4.6 3.6

...... 59.1 81.7 80.9 77.9 80.0 79.7 80.9 80.3 75.3 81.3

...... 10.4 10.7 10.9 9.6 10.4 10.1 11.2 10.5 9.3 10.6

. . . . . . 1.6 1.4 1.6 1.5 1.9 1.5 1.8 1.6 1.6 1.5

. . . . . . 2.4 2.6 2.8 2.0 2.2 2.4 2.5 2.5 2.0 2.4

. . . . . . 3.5 3.7 3.6 3.2 3.4 3.4 3.7 3.5 3.0 3.6

. . . . . . 2.9 2.9 2.9 2.9 2.8 2.8 3.2 2.9 2.8 3.0

...... 15.5 17.4 15.6 14.5 15.1 15.1 14.7 16.1 12.2 15.5

. . . . . . 1.6 2.1 1.6 1.2 1.4 1.5 1.7 1.7 1.1 1.4

. . . . . . 1.4 1.7 1.5 1.3 1.2 1.4 1.6 1.5 1.1 1.4

. . . . . . 3.2 3.5 3.6 2.8 2.8 3.1 3.4 3.2 2.9 3.1

. . . . . . 2.9 2.9 2.5 2.9 3.3 2.5 1.8 3.1 1.9 2.6

. . . . . . 3.3 3.5 3.0 3.3 3.6 3.4 3.0 3.3 2.5 3.9

. . . . . . 3.2 3.7 3.2 3.1 2.7 3.2 3.2 3.3 2.7 3.1

...... 21.7 22.2 21.8 21.5 22.8 22.0 21.8 21.7 21.2 23.2

. . . . . . 7.9 7.6 7.7 8.1 8.2 8.1 7.2 7.9 8.1 7.9

. . . . . . 7.9 5.8 6.5 5.4 6.1 5.9 6.0 6.0 5.4 5.9

. . . . . . 5.9 8.8 7.5 8.1 8.5 8.0 8.6 7.9 7.6 9.4

. . . . . . 5.5 18.0 17.3 17.8 16.9 18.2 18.7 17.7 16.0 17.7

. . . . . . 1.2 1.6 1.2 0.9 1.4 2.2 1.4 1.3 0.9 1.1

. . . . . . 1.2 3.6 2.7 3.0 2.9 2.9 3.4 2.9 3.4 3.3

. . . . . . 3.0 12.8 13.4 13.9 12.5 13.1 14.0 13.5 11.7 13.3

...... 14.6 13.5 15.3 14.4 14.9 14.7 14.4 14.3 16.6 14.4

skull

. . . . . . 2.3 2.1 2.5 2.0 2.6 2.4 1.8 2.3 2.6 2.2

. . . . . . 1.8 1.7 2.0 1.5 2.1 1.7 2.0 1.8 2.0 1.7

. . . . . . 1.8 1.6 2.0 1.8 1.6 1.8 1.6 1.8 1.8 1.6

. . . . . . 3.7 3.1 4.1 4.0 3.4 3.7 3.8 3.6 5.0 3.5

. . . . . . 2.6 2.2 2.9 2.5 2.7 2.5 2.9 2.5 2.8 2.9

. . . . . . 1.9 2.2 1.6 1.9 1.9 1.9 1.8 1.9 1.7 1.9

. . . . . . 0.5 0.6 0.3 0.6 0.6 0.5 0.6 0.4 0.7 0.7

encing

ces . . . . 3.0 2.8 2.8 3.2 3.3 3.2 2.4 2.9 4.2 2.7

. . . . . . 1.8 1.6 1.5 2.4 1.8 1.9 1.8 1.8 2.3 1.8

Series 13, No. 131 [ Page 41
department injury visits by principal diagnosis, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95

oup Total

Geographic region Metropolitan status

Northeast Midwest South West Metropolitan

Nonmetropolitan

Number of visits per 1,000 persons

............... 143.2 152.7 167.5 132.1 125.4 142.1 147.6

............... 21.7 21.2 24.9 21.7 18.8 21.6 22.1

. . . . . . . . . . . . . . . 5.8 5.1 6.3 6.0 5.4 5.6 6.3

. . . . . . . . . . . . . . . 4.2 3.2 5.0 4.3 3.9 4.1 4.4

. . . . . . . . . . . . . . . 2.4 2.9 2.8 2.1 2.1 2.2 3.1

. . . . . . . . . . . . . . . 2.2 2.9 2.3 1.7 2.2 2.3 1.8

. . . . . . . . . . . . . . . 1.9 2.1 2.0 1.7 1.7 1.9 1.8

. . . . . . . . . . . . . . . 5.3 5.0 6.5 6.0 3.5 5.5 4.7

............... 84.6 124.8 135.5 102.9 100.3 113.2 119.4

............... 14.8 16.3 18.3 12.7 13.0 14.3 16.6

. . . . . . . . . . . . . . . 2.3 2.1 2.7 2.0 2.4 2.1 2.7

. . . . . . . . . . . . . . . 3.4 4.0 4.7 2.6 2.8 3.4 3.7

. . . . . . . . . . . . . . . 5.0 5.7 6.0 4.2 4.3 4.8 5.5

. . . . . . . . . . . . . . . 4.1 4.5 4.9 3.8 3.5 4.0 4.7

............... 22.2 26.6 26.1 19.2 18.9 21.4 21.7

. . . . . . . . . . . . . . . 2.2 3.2 2.8 1.6 1.8 2.1 2.6

. . . . . . . . . . . . . . . 2.1 2.7 2.5 1.7 1.5 2.0 2.3

. . . . . . . . . . . . . . . 4.5 5.3 6.0 3.7 3.5 4.4 5.0

. . . . . . . . . . . . . . . 4.1 4.5 4.2 3.9 4.2 3.5 2.7

. . . . . . . . . . . . . . . 4.8 5.3 5.1 4.3 4.6 4.8 4.5

. . . . . . . . . . . . . . . 4.5 5.6 5.4 4.0 3.4 4.5 4.7

............... 31.1 33.9 36.5 28.4 28.5 31.3 32.2

. . . . . . . . . . . . . . . 11.3 11.7 13.0 10.7 10.3 11.5 10.6

. . . . . . . . . . . . . . . 11.3 8.8 11.0 7.1 7.6 8.4 8.9

. . . . . . . . . . . . . . . 8.5 13.4 12.6 10.7 10.7 11.4 12.7

. . . . . . . . . . . . . . . 7.8 27.4 28.9 23.6 21.1 25.9 27.7

. . . . . . . . . . . . . . . 1.8 2.4 2.0 1.2 1.8 3.2 2.0

. . . . . . . . . . . . . . . 1.8 5.5 4.4 4.0 3.6 4.1 5.0

. . . . . . . . . . . . . . . 4.3 19.5 22.5 18.3 15.7 18.6 20.7

............... 20.9 20.6 25.7 19.1 18.7 20.8 21.2

skull fractures . . . . . . 3.3 3.3 4.2 2.7 3.3 3.5 2.7

. . . . . . . . . . . . . . . 2.6 2.6 3.3 2.0 2.6 2.5 3.0

. . . . . . . . . . . . . . . 2.5 2.5 3.3 2.4 2.0 2.6 2.3

. . . . . . . . . . . . . . . 5.3 4.7 6.9 5.2 4.3 5.3 5.6

. . . . . . . . . . . . . . . 3.7 3.3 4.9 3.4 3.3 3.6 4.2

al causes . . . . . . . . . 2.7 3.3 2.7 2.6 2.3 2.7 2.6

care, NEC1 . . . . . . . . 0.7 1.0 0.5 0.8 0.8 0.7 0.9

encing

ces . . . . . . . . . . . . . 4.3 4.3 4.7 4.3 4.1 4.6 3.5

. . . . . . . . . . . . . . . 2.6 2.4 2.5 3.1 2.2 2.6 2.6

Page 42 [ Series 13, No. 131
nt distribution of injury-related emergency department visits by the 20 most frequent principal diagnoses, according to patient’s age, sex, and

: United States, 1992–95

d

1 Total

Patient age Sex Race2

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

............. 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

. . . . . . . . . . 873 2,659 708 613 397 536 200 206 861 1,798 2,185 401

back . . . . . . . 847 1,891 * 86 482 936 288 89 945 947 1,483 356

ed sites . . . . . 924 1,871 86 309 415 630 246 185 1,008 863 1,505 323

. . . . . . . . . . 883 1,509 67 135 358 651 225 71 503 1,005 1,262 207

. . . . . . . . . . 845 1,370 30 251 420 503 122 44 663 707 1,190 161

. . . . . . . . . . 923 1,265 80 239 327 408 135 77 612 653 1,095 150

except limbs . 879 1,185 150 221 226 357 144 86 441 744 953 183

eyes . . . . . . . 920 905 185 162 242 191 55 71 458 446 712 166

. . . . . . . . . . 959 769 68 125 177 266 84 52 328 441 599 156

. . . . . . . . . . 922 702 22 97 137 242 106 98 324 378 587 92

. . . . . . . . . . 882 669 26 69 168 286 74 47 175 494 570 88

nature . . . . . . 854 648 170 136 115 147 44 36 245 403 518 111

ified . . . . . . . 995 598 70 71 95 238 82 43 402 197 453 128

. . . . . . . . . . 813 581 48 271 52 77 60 73 281 300 515 48

. . . . . . . . . . 842 572 * 154 154 190 41 20 235 337 498 65

. . . . . . . . . . 848 534 * 53 128 232 78 39 269 266 393 116

. . . . . . . . . . 844 527 * 65 135 223 68 31 227 300 450 70

. . . . . . . . . . 918 502 37 57 81 245 65 * 214 287 431 64

d ankle . . . . . 891 497 * 156 121 129 44 28 178 319 410 72

. . . . . . . . . . 724 419 * * 54 245 70 34 200 218 337 72

............. 17,113 1,698 2,253 3,126 5,615 2,317 2,102 7,669 9,444 13,850 2,882

Percent distribution

............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

. . . . . . . . . . 873 7.2 20.2 11.1 5.4 4.3 4.4 6.0 5.3 8.7 7.3 6.8

back . . . . . . . 847 5.1 * 1.5 6.5 7.6 6.3 2.6 5.8 4.6 4.9 6.0

ed sites . . . . . 924 5.1 2.5 5.6 5.6 5.1 5.4 5.4 6.2 4.2 5.0 5.5

. . . . . . . . . . 883 4.1 1.9 2.4 4.8 5.3 5.0 2.1 3.1 4.9 4.2 3.5

. . . . . . . . . . 845 3.7 0.9 4.5 5.7 4.1 2.7 1.3 4.1 3.4 4.0 2.7

. . . . . . . . . . 923 3.4 2.3 4.3 4.4 3.3 3.0 2.2 3.8 3.2 3.6 2.5

except limbs . 879 3.2 4.3 4.0 3.0 2.9 3.2 2.5 2.7 3.6 3.2 3.1

eyes . . . . . . . 920 2.5 5.3 2.9 3.3 1.5 1.2 2.1 2.8 2.2 2.4 2.8

. . . . . . . . . . 959 2.1 2.0 2.3 2.4 2.2 1.8 1.5 2.0 2.1 2.0 2.6

. . . . . . . . . . 922 1.9 0.6 1.7 1.9 2.0 2.3 2.8 2.0 1.8 2.0 1.6

. . . . . . . . . . 882 1.8 0.7 1.2 2.3 2.3 1.6 1.4 1.1 2.4 1.9 1.5

nature . . . . . . 854 1.8 4.9 2.4 1.6 1.2 1.0 1.0 1.5 2.0 1.7 1.9

ified . . . . . . . 995 1.6 2.0 1.3 1.3 1.9 1.8 1.2 2.5 1.0 1.5 2.2

. . . . . . . . . . 813 1.6 1.4 4.9 0.7 0.6 1.3 2.1 1.7 1.5 1.7 0.8

. . . . . . . . . . 842 1.6 * 2.8 2.1 1.5 0.9 0.6 1.5 1.6 1.7 1.1

. . . . . . . . . . 848 1.5 * 0.9 1.7 1.9 1.7 1.1 1.7 1.3 1.3 2.0

. . . . . . . . . . 844 1.4 * 1.2 1.8 1.8 1.5 0.9 1.4 1.5 1.5 1.2

. . . . . . . . . . 918 1.4 1.1 1.0 1.1 2.0 1.4 * 1.3 1.4 1.4 1.1

d ankle . . . . . 891 1.4 * 2.8 1.6 1.0 1.0 0.8 1.1 1.6 1.4 1.2

. . . . . . . . . . 724 1.1 * * 0.7 2.0 1.5 1.0 1.2 1.1 1.1 1.2

............. 46.5 48.5 40.7 42.2 45.5 51.0 61.0 47.2 46.0 46.2 48.7

cision. 1Based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9–CM),(8). 

ve been omitted because of small sample sizes.

Series 13, No. 131 [ Page 43
nt distribution of injury-related emergency department visits by the 20 most frequent principal diagnoses, according to hospital characteristics,

ed States, 1992–95

d

1 Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

Nonmetropolitan Voluntary, nonprofit Non-Federal government Proprietary

Number of visits in thousands

............. 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

. . . . . . . . . . 873 2,659 531 745 847 535 2,129 530 1,806 299 554

back . . . . . . . 847 1,891 415 469 606 402 1,588 303 1,336 153 402

ed sites . . . . . 924 1,871 360 532 636 344 1,445 426 1,287 170 414

. . . . . . . . . . 883 1,509 321 470 433 285 1,167 341 1,050 140 318

. . . . . . . . . . 845 1,370 308 438 389 235 1,054 316 955 129 285

. . . . . . . . . . 923 1,265 266 374 395 231 945 321 912 123 231

except limbs . 879 1,185 367 287 329 201 897 287 781 104 300

eyes . . . . . . . 920 905 194 268 287 157 726 179 620 85 199

. . . . . . . . . . 959 769 127 251 277 114 588 181 494 127 148

. . . . . . . . . . 922 702 143 198 231 129 533 169 474 70 158

. . . . . . . . . . 882 669 125 212 188 143 523 146 455 77 137

nature . . . . . . 854 648 112 208 175 152 541 106 442 80 126

ified . . . . . . . 995 598 144 137 199 118 479 119 412 62 125

. . . . . . . . . . 813 581 105 166 173 136 435 146 404 63 114

. . . . . . . . . . 842 572 159 172 139 102 432 140 418 44 111

. . . . . . . . . . 848 534 162 152 161 59 413 121 389 49 96

. . . . . . . . . . 844 527 135 158 151 84 401 126 378 44 105

. . . . . . . . . . 918 502 132 140 112 118 371 131 370 40 91

d ankle . . . . . 891 497 89 125 184 100 371 126 334 44 120

. . . . . . . . . . 724 419 62 108 153 95 313 106 259 54 106

............. 17,113 3,455 4,818 5,499 3,341 13,373 3,740 11,532 2,053 3,528

Percent distribution

............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

. . . . . . . . . . 873 7.2 6.9 7.1 7.3 7.6 7.4 6.6 7.2 7.4 7.2

back . . . . . . . 847 5.1 5.4 4.5 5.2 5.7 5.5 3.8 5.3 3.8 5.2

ed sites . . . . . 924 5.1 4.7 5.1 5.5 4.9 5.0 5.3 5.1 4.2 5.4

. . . . . . . . . . 883 4.1 4.2 4.5 3.7 4.0 4.1 4.2 4.2 3.5 4.1

. . . . . . . . . . 845 3.7 4.0 4.2 3.4 3.3 3.7 3.9 3.8 3.2 3.7

. . . . . . . . . . 923 3.4 3.4 3.6 3.4 3.3 3.3 4.0 3.6 3.1 3.0

except limbs . 879 3.2 4.8 2.8 2.8 2.8 3.1 3.6 3.1 2.6 3.9

eyes . . . . . . . 920 2.5 2.5 2.6 2.5 2.2 2.5 2.2 2.5 2.1 2.6

. . . . . . . . . . 959 2.1 1.6 2.4 2.4 1.6 2.0 2.2 2.0 3.2 1.9

. . . . . . . . . . 922 1.9 1.9 1.9 2.0 1.8 1.9 2.1 1.9 1.7 2.1

. . . . . . . . . . 882 1.8 1.6 2.0 1.6 2.0 1.8 1.8 1.8 1.9 1.8

nature . . . . . . 854 1.8 1.5 2.0 1.5 2.2 1.9 1.3 1.8 2.0 1.6

ified . . . . . . . 995 1.6 1.9 1.3 1.7 1.7 1.7 1.5 1.6 1.5 1.6

. . . . . . . . . . 813 1.6 1.4 1.6 1.5 1.9 1.5 1.8 1.6 1.6 1.5

. . . . . . . . . . 842 1.6 2.1 1.6 1.2 1.4 1.5 1.7 1.7 1.1 1.4

. . . . . . . . . . 848 1.5 2.1 1.5 1.4 0.8 1.4 1.5 1.6 1.2 1.3

. . . . . . . . . . 844 1.4 1.7 1.5 1.3 1.2 1.4 1.6 1.5 1.1 1.4

. . . . . . . . . . 918 1.4 1.7 1.3 1.0 1.7 1.3 1.6 1.5 1.0 1.2

d ankle . . . . . 891 1.4 1.2 1.2 1.6 1.4 1.3 1.6 1.3 1.1 1.6

. . . . . . . . . . 724 1.1 0.8 1.0 1.3 1.3 1.1 1.3 1.0 1.4 1.4

............. 46.5 44.8 46.2 47.5 47.2 46.6 46.4 45.9 51.2 46.0

ses, 9th Revision, Clinical Modification (ICD–9–CM),(8).

Page 44 [ Series 13, No. 131
nt distribution for emergency department injury visits by principal diagnosis for selected causes of injury, averaged over a 4-year period:

All

uses

Selected causes of injury

Falls

Struck by/

against

Motor

vehicle

traffic

Cut/

pierce Overexertion

Natural/

environmental Poisoning

Fire/burn

Other

pedal

cycle Machinery Firearm

Other

transportation

Other

causes

Blank

causes

Number of visits in thousands

,785 7,847 4,351 3,956 3,189 1,597 1,503 877 597 493 314 164 287 7,456 4,154

,580 833 320 438 106 346 237 221 27 22 * * 22 1,082 1,905

,413 6,795 3,863 3,238 2,950 1,213 1,215 623 560 459 290 154 258 5,945 1,852

,808 1,787 539 250 29 117 20 * * 84 47 * 54 719 149

,712 1,328 284 1,200 * 963 * * * 35 20 * 41 1,240 590,085 1,431 1,216 316 2,761 * 491 * * 153 150 125 58 1,045 328,442 1,604 1,436 1,039 130 48 286 * * 128 46 * 68 1,356 269,367 646 389 433 26 80 412 616 538 59 28 * 37 1,585 516

,115 111 89 180 92 21 36 * * * * * * 283 264

676 108 78 100 41 17 * * * * * * * 146 133

Percent distribution

00.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

15.2 10.6 7.4 11.1 3.3 21.7 15.8 25.3 4.5 4.6 * * 7.7 14.5 45.9

80.0 86.6 88.8 81.8 92.5 75.9 80.8 71.1 93.7 93.1 92.3 93.8 89.9 79.7 44.6

10.4 22.8 12.4 6.3 0.9 7.3 1.3 * * 17.0 14.8 * 18.8 9.6 3.6

15.5 16.9 6.5 30.3 * 60.3 * * * 7.1 6.3 * 14.3 16.6 14.222.0 18.2 27.9 8.0 86.6 * 32.7 * * 31.1 47.7 76.3 20.0 14.0 7.917.5 20.4 33.0 26.3 4.1 3.0 19.0 * * 26.1 14.6 * 23.7 18.2 6.514.6 8.2 8.9 10.9 0.8 5.0 27.4 70.2 90.0 11.9 8.9 * 13.1 21.3 12.4

3.0 1.4 2.1 4.6 2.9 1.3 2.4 * * * * * * 3.8 6.4

1.8 1.4 1.8 2.5 1.3 1.1 * * * * * * * 2.0 3.2

Percent distribution

00.0 21.3 11.8 10.8 8.7 4.3 4.1 2.4 1.6 1.3 0.9 0.4 0.8 20.3 11.300.0 14.9 5.7 7.9 1.9 6.2 4.3 4.0 0.5 0.4 * * 0.4 19.4 34.100.0 23.1 13.1 11.0 10.0 4.1 4.1 2.1 1.9 1.6 1.0 0.5 0.9 20.2 6.3

00.0 46.9 14.2 6.6 0.8 3.1 0.5 * * 2.2 1.2 * 1.4 18.9 3.9

00.0 23.2 5.0 21.0 * 16.9 * * * 0.6 0.3 * 0.7 21.7 10.300.0 17.7 15.0 3.9 34.2 * 6.1 * * 1.9 1.9 1.5 0.7 12.9 4.100.0 24.9 22.3 16.1 2.0 0.7 4.4 * * 2.0 0.7 * 1.1 21.1 4.200.0 12.0 7.2 8.1 0.5 1.5 7.7 11.5 10.0 1.1 0.5 * 0.7 29.5 9.600.0 10.0 8.0 16.2 8.3 1.9 3.2 * * * * * * 25.4 23.700.0 16.0 11.6 14.8 6.1 2.5 * * * * * * * 21.6 19.6

cision.

Series 13, No. 131 [ Page 45
Table 25. Annual number and percent of emergency department injury visits by disposition, according to patient age, sex, and race,

averaged over a 4-year period: United States, 1992–95

Disposition Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits .............. 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Refer to other clinic ........... 14,488 1,243 2,162 3,043 5,179 1,802 1,061 6,360 8,128 11,454 2,615

Return as needed ............ 10,370 1,109 1,658 2,118 3,545 1,218 722 4,569 5,802 8,474 1,669

Return to referring physician ..... 8,292 845 1,395 1,664 2,584 1,046 788 3,891 4,401 7,161 1,006

No followup ................ 3,011 328 490 640 979 343 230 1,325 1,687 2,389 539

Admit to hospital ............. 2,322 109 117 325 579 387 804 1,151 1,171 1,980 302

Return for appointment ......... 2,125 239 349 452 757 218 109 734 1,391 1,745 334

Transfer to other facility . . . . . . . . 617 48 71 93 213 80 113 286 331 507 96

Dead/DOA2 . . . . . . . . . . . . . . . . 49 * * * * * * * 40 37 *

Other .................... 1,242 134 145 247 462 152 102 519 724 986 216

Percent of injury visits

All injury visits . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ... ...

Refer to other clinic ........... 39.4 35.5 39.1 41.1 41.9 39.6 30.8 39.2 39.6 38.2 44.2

Return as needed ............ 28.2 31.7 30.0 28.6 28.7 26.8 20.9 28.1 28.2 28.2 28.2

Return to referring physician ..... 22.5 24.2 25.2 22.5 20.9 23.0 22.9 24.0 21.4 23.9 17.0

No followup . . . . . . . . . . . . . . . . 8.2 9.4 8.9 8.6 7.9 7.6 6.7 8.2 8.2 8.0 9.1

Admit to hospital . . . . . . . . . . . . . 6.3 3.1 2.1 4.4 4.7 8.5 23.3 7.1 5.7 6.6 5.1

Return for appointment . . . . . . . . . 7.7 9.0 8.2 8.1 8.2 6.4 4.2 5.9 9.0 7.7 7.4

Transfer to other facility . . . . . . . . 1.7 1.4 1.3 1.3 1.7 1.8 3.3 1.8 1.6 1.7 1.6

Dead/DOA2 . . . . . . . . . . . . . . . . 0.1 * * * * * * * 0.2 0.1 *

Other . . . . . . . . . . . . . . . . . . . . 3.4 3.8 2.6 3.3 3.7 3.3 3.0 3.2 3.5 3.3 3.7

Percent of emergency department visits that are injury related

All injury visits .............. 39.8 27.8 53.5 48.5 43.8 35.0 26.3 33.8 46.3 41.7 32.3

Refer to other clinic ........... 41.9 25.5 53.7 47.2 44.9 39.7 34.1 35.4 49.1 44.7 33.1

Return as needed ............ 42.8 29.0 52.2 48.7 46.1 40.3 33.3 36.3 49.7 45.2 33.8

Return to referring physician ..... 39.5 26.4 54.1 48.5 41.2 36.1 29.3 33.9 46.3 41.3 30.8

No followup ................ 42.7 29.4 49.6 50.0 43.3 40.8 40.8 36.4 49.4 45.1 34.6

Admit to hospital ............. 19.4 15.8 30.7 35.7 25.3 15.5 15.5 18.1 20.9 19.9 17.4

Return for appointment ......... 66.9 54.7 78.6 70.4 71.9 57.3 49.6 55.0 75.4 71.3 51.0

Transfer to other facility ........ 41.1 36.4 67.9 49.1 44.6 32.3 32.0 40.3 41.7 42.8 38.0

Dead/DOA2 ................ 17.8 * * * * * * * 25.2 16.7 *

Other .................... 39.4 33.8 50.3 46.3 40.0 34.0 30.8 32.4 46.6 42.0 31.0

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

1Estimates for races other than white and black have been omitted because of small sample sizes.

2DOA is dead on arrival.

Page 46 [ Series 13, No. 131
Table 26. Annual number and percent of emergency department injury visits by disposition, according to hospital characteristics, averaged

over a 4-year period: United States, 1992–95

Disposition Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits .............. 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Refer to other clinic ........... 14,488 3,407 4,071 4,439 2,571 11,843 2,645 9,736 1,583 3,170

Return as needed ............ 10,370 2,476 2,896 2,896 2,103 8,478 1,892 6,943 1,214 2,214

Return to referring physician ..... 8,292 1,418 3,090 2,366 1,418 6,503 1,789 6,389 425 1,477

No followup ................ 3,011 557 595 1,256 603 1,971 1,040 1,942 393 676

Admit to hospital ............. 2,322 457 781 701 382 1,809 513 1,595 311 416

Return for appointment ......... 2,125 458 407 645 616 1,712 413 1,272 312 541

Transfer to other facility . . . . . . . . 617 90 192 226 110 394 223 394 105 118

Dead/DOA1 . . . . . . . . . . . . . . . . 49 * * * * 36 * 28 * *

Other .................... 1,242 230 317 472 223 883 359 878 153 212

Percent of injury visits

All injury visits . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ...

Refer to other clinic ........... 39.4 44.2 39.0 38.4 36.3 41.2 32.8 38.8 39.5 41.4

Return as needed ............ 28.2 32.1 27.8 25.0 29.7 29.5 23.5 27.7 30.3 28.9

Return to referring physician ..... 22.5 18.4 29.6 20.5 20.0 22.6 22.2 25.4 10.6 19.3

No followup . . . . . . . . . . . . . . . . 8.2 7.2 5.7 10.9 8.5 6.9 12.9 7.7 9.8 8.8

Admit to hospital . . . . . . . . . . . . . 6.3 5.9 7.5 6.1 5.4 6.3 6.4 6.4 7.7 5.4

Return for appointment . . . . . . . . . 5.8 5.9 3.9 5.6 8.7 6.0 5.1 5.1 7.8 7.1

Transfer to other facility . . . . . . . . 1.7 1.2 1.8 2.0 1.5 1.4 2.8 1.6 2.6 1.5

Dead/DOA1 . . . . . . . . . . . . . . . . 0.1 * * * * 0.1 * 0.1 * *

Other . . . . . . . . . . . . . . . . . . . . 3.4 3.0 3.0 4.1 3.1 3.1 4.5 3.5 3.8 2.8

Percent of emergency department visits that are injury related

All injury visits .............. 39.8 40.8 40.8 37.6 40.8 39.9 39.5 40.8 34.4 39.8

Refer to other clinic ........... 39.8 41.9 45.0 40.1 40.7 41.6 43.5 43.7 33.5 42.2

Return as needed ............ 42.8 43.7 42.1 40.8 45.7 43.1 38.9 39.8 34.7 45.8

Return to referring physician ..... 39.8 40.9 43.7 36.1 36.5 40.1 37.4 41.1 32.0 35.9

No followup ................ 42.7 48.1 41.3 40.7 44.1 42.6 42.9 44.8 37.8 40.2

Admit to hospital ............. 19.4 18.4 20.5 18.9 19.6 19.4 19.6 19.3 24.0 17.4

Return for appointment ......... 66.9 71.1 66.9 59.0 73.8 67.5 64.5 71.0 48.0 73.4

Transfer to other facility ........ 41.1 34.7 43.1 41.7 38.3 39.2 44.9 41.3 46.4 36.6

Dead/DOA1 ................ 17.8 * * * * 17.7 * 17.2 * *

Other .................... 39.4 41.4 39.9 37.7 40.6 39.0 40.5 39.6 36.5 41.0

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

1DOA is dead on arrival.

Series 13, No. 131 [ Page 47
Table 27. Annual number, percent distribution, and rate of injury-related emergency department visits that ended in admission to inpatient

status by patient characteristics, averaged over a 4-year period: United States, 1992–95

Patient characteristic

Number of

injury visits

in thousands

Number of

admissions

in thousands

Percent

distribution

Percent of

injury visits

resulting in

admission

status

Number of

admissions

per 10,000

persons

per year1

All injury-related visits ................... 36,785 2,322 100.0 6.3 90.4

Age

Under 5 years ........................ 3,499 109 4.7 3.1 54.0

5–14 years .......................... 5,535 117 5.1 2.1 30.9

15–24 years ......................... 7,410 325 14.0 4.4 92.3

25–44 years ......................... 12,348 579 24.9 4.7 70.4

45–64 years ......................... 4,546 387 16.7 8.5 77.3

65 years and over ...................... 3,448 804 34.6 23.3 258.2

Sex and age

Female ............................ 16,239 1,151 49.6 7.1 87.3

Under 5 years ....................... 1,515 59 2.6 3.9 60.6

5–14 years ......................... 2,233 53 2.3 2.4 28.4

15–24 years ........................ 2,915 109 4.7 3.7 61.7

25–44 years ........................ 5,087 210 9.1 4.1 50.3

45–64 years ........................ 2,243 174 7.5 7.8 67.2

65 years and over .................... 2,247 545 23.5 24.3 300.8

Male .............................. 20,546 1,171 50.4 5.7 93.7

Under 5 years ....................... 1,984 49 2.1 2.5 47.8

5–14 years ......................... 3,302 65 2.8 2.0 33.3

15–24 years ........................ 4,495 217 9.3 4.8 122.9

25–44 years ........................ 7,260 369 15.9 5.1 91.1

45–64 years ........................ 2,304 213 9.2 9.2 88.1

65 years and over .................... 1,201 259 11.2 21.6 198.9

Race and age

White ............................. 29,998 1,980 85.3 6.6 93.0

Under 5 years ....................... 2,735 85 3.7 3.1 53.9

5–14 years ......................... 4,533 96 4.1 2.1 31.8

15–24 years ........................ 6,022 266 11.5 4.4 94.7

25–44 years ........................ 9,814 449 19.4 4.6 66.0

45–64 years ........................ 3,766 331 14.3 8.8 76.9

65 years and over .................... 3,128 753 32.4 24.1 270.2

Black .............................. 5,912 302 13.0 5.1 92.9

Under 5 years . . . . . . . . . . . . . . . . . . . . . . . 669 21 0.9 3.1 63.3

5–14 years . . . . . . . . . . . . . . . . . . . . . . . . . 869 * * * *

15–24 years ........................ 1,231 54 2.3 4.4 103.1

25–44 years ........................ 2,212 118 5.1 5.3 115.8

45–64 years . . . . . . . . . . . . . . . . . . . . . . . . 660 43 1.9 6.5 83.6

65 years and over . . . . . . . . . . . . . . . . . . . . 272 48 2.1 17.6 183.8

All other races . . . . . . . . . . . . . . . . . . . . . . . . 875 39 1.7 4.5 34.9

Asian/Pacific Islander . . . . . . . . . . . . . . . . . . 624 18 0.8 2.9 . . .

American Indian/Eskimo/Aleut . . . . . . . . . . . . . 251 21 0.9 8.5 . . .

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

1Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

Page 48 [ Series 13, No. 131
Table 28. Annual number, percent distribution, and rate of injury-related emergency department visits that ended in admission to inpatient

status by hospital characteristics, averaged over a 4-year period: United States, 1992–95

Hospital characteristic

Number of

injury visits

in thousands

Number of

admissions

in thousands

Percent

distribution

Percent of

injury visits

resulting in

admission

status

Number of

admissions

per 10,000

persons

per year1

All injury-related visits ................... 36,785 2,322 100.0 6.3 90.4

Geographic region

Northeast ........................... 7,713 457 19.7 5.9 90.5

Midwest ............................ 10,427 781 33.6 7.5 125.5

South ............................. 11,565 701 30.2 6.1 80.1

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,081 382 16.4 5.4 67.6

Metropolitan status

Metropolitan ......................... 28,723 1,809 77.9 6.3 89.5

Nonmetropolitan ....................... 8,062 513 22.1 6.4 93.9

Ownership

Voluntary, not for profit ................... 25,109 1,595 68.7 6.4 . . .

Non-Federal government ................. 4,011 311 13.4 7.7 . . .

Proprietary .......................... 7,666 416 17.9 5.4 . . .

. . . Category not applicable.

1Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

Table 29. Annual number, percent distribution, and rate of emergency department injury visits by mechanism that caused the injury ending

in admission to inpatient status, averaged over a 4-year period: United States, 1992–95

Mechanism

Number of

injury visits

in thousands

Number of

admissions

in thousands

Percent

distribution

Percent of

injury visits

resulting in

admission

status

Number of

admissions

per 10,000

persons

per year1

All injury visits ........................ 36,785 2,322 100.0 6.3 90.4

Fall ............................... 7,847 716 30.9 9.1 27.9

Struck by or against a person or object ......... 4,351 74 3.2 1.7 2.9

Motor vehicle traffic ..................... 3,956 297 12.8 7.5 11.6

Cut/pierce ........................... 3,189 90 3.9 2.8 3.5

Overexertion ......................... 1,597 28 1.2 1.8 1.1

Natural/environmental ................... 1,503 36 1.5 2.4 1.4

Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 877 208 8.9 23.7 8.1

Fire/burn . . . . . . . . . . . . . . . . . . . . . . . . . . . 597 * * * *

Other pedal cycle . . . . . . . . . . . . . . . . . . . . . . 493 * * * *

Machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . 314 * * * *

Firearm . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 64 2.8 39.2 2.5

Other transportation . . . . . . . . . . . . . . . . . . . . . 287 * * * *

Suffocation . . . . . . . . . . . . . . . . . . . . . . . . . . 98 * * * *

Other mechanism2 ..................... 2,065 50 2.1 2.4 1.9

Not elsewhere classified . . . . . . . . . . . . . . . . . . 433 * * * *

Mechanism not specified ................. 4,861 241 10.4 5.0 9.4

Blank cause of injury .................... 4,154 416 17.9 10.0 16.2

* Figure does not meet standard of reliability or precision.

1Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

2Includes other pedestrian and drowning.

Series 13, No. 131 [ Page 49
Table 30: Annual number and percent distribution of emergency department injury visits by principal diagnosis ending in admission to

inpatient status, averaged over a 4-year period: United States, 1992–95

Principal diagnosis group

Number of

injury visits

in thousands

Number of

admissions

in thousands

Percent

distribution

Percent of

injury visits

resulting in

admission

status

Number of

admissions

per 10,000

persons

per year1

Number of visits in thousands

All injury visits ............................... 36,785 2,322 100.0 6.3 90.4

Illness diagnoses ............................. 5,580 787 33.9 14.1 30.6

Musculoskeletal system ........................ 1,481 57 2.4 3.8 2.2

Symptoms and ill-defined conditions ................ 1,072 220 9.5 20.5 8.6

Skin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . 618 56 2.4 9.1 2.2

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 559 126 5.4 22.5 4.9

Nervous system and sense organs . . . . . . . . . . . . . . . . . 477 * * * *

Other illnesses ............................. 1,373 318 13.7 23.1 12.4

Injury and poisoning ........................... 21,726 1,467 63.2 6.8 57.1

Fractures ................................. 3,808 560 24.1 14.7 21.8

Fracture of radius and ulna . . . . . . . . . . . . . . . . . . . . 581 31 1.3 5.4 1.2

Fracture of hand and fingers . . . . . . . . . . . . . . . . . . . 885 * * * *

Fracture of lower limb ........................ 1,277 341 14.7 26.7 13.3

Other fractures ............................ 1,065 173 7.5 16.2 6.7

Sprains and strains ........................... 5,712 32 1.4 0.6 1.2

Sprains and strains of wrist and hand . . . . . . . . . . . . . . 572 * * * *

Sprains and strains of knee and leg . . . . . . . . . . . . . . . 527 * * * *

Sprains and strains of ankle .................... 1,159 * * * *

Sprains and strains of neck .................... 1,063 * * * *

Other sprains and strains of back ................ 1,223 * * * *

Other sprains and strains ..................... 1,168 * * * *

Open wounds .............................. 7,998 215 9.3 2.7 8.4

Open wound of head ........................ 2,910 61 2.6 2.1 2.4

Open wound of hand and fingers ................. 2,910 20 0.9 0.7 0.8

Other open wound .......................... 2,178 133 5.7 6.1 5.2

Superficial injuries ........................... 2,014 72 3.1 3.6 2.8

Superficial injury of cornea . . . . . . . . . . . . . . . . . . . . . 452 * * * *

Other superficial injury . . . . . . . . . . . . . . . . . . . . . . . 452 * * * *

Contusions with intact skin surfaces . . . . . . . . . . . . . . . 1,110 60 2.6 5.4 2.3

Other injuries .............................. 5,367 589 25.4 11.0 22.9

Intracranial injury, excluding those with skull fractures . . . . 847 132 5.7 15.6 5.1

Foreign body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 661 27 1.2 4.1 1.0

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 655 18 0.8 2.8 0.7

Other injuries ............................. 1,369 167 7.2 12.2 6.5

Poisonings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 953 190 8.2 19.9 7.4

Other and unspecified effects of external causes . . . . . . . 691 27 1.1 3.8 1.0

Complications of surgical and medical care, NEC2 . . . . . . 191 28 1.2 14.6 1.1

Supplementary classification of factors influencing health

status and contact with health services . . . . . . . . . . . . . . . 1,115 21 0.9 1.9 0.8

Unknown and blank . . . . . . . . . . . . . . . . . . . . . . . . . . . . 676 46 2.0 6.8 1.8

* Figure does not meet standard of reliability or precision.

1Based on an average of U.S. Bureau of the Census estimates of the civilian, noninstitutionalized population of the United States, July 1, 1992–95.

2NEC is not elsewhere classified.

Page 50 [ Series 13, No. 131
nt distribution of injury-related emergency department visits by the 20 most frequent principal reasons for visit, according to patient’s age, sex,

Total

Patient age Sex Race2

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

........... 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

....... J225 2,429 95 235 613 1,022 303 162 717 1,712 2,045 322

....... J210 1,577 464 384 228 302 101 99 501 1,076 1,287 260

d ...... J505 1,448 297 304 276 334 125 108 590 858 1,158 254

....... S905 1,222 * 59 245 591 196 122 578 644 993 206

....... J570 1,149 72 234 283 404 116 39 390 759 956 167

....... S960 1,071 48 207 265 383 109 58 430 642 925 132

....... S900 974 * 61 270 458 140 31 509 465 761 189

....... J810 966 163 146 105 206 121 225 510 456 797 141

....... S925 796 * 98 190 308 115 82 350 446 643 128....... S930 783 * 119 221 299 85 41 366 417 686 87

....... J805 739 54 84 199 257 104 41 394 345 570 152

....... S940 737 15 85 144 273 110 109 326 411 613 113

....... S935 727 38 112 139 278 102 46 371 356 608 109

a ...... J205 711 171 162 107 141 75 86 230 481 592 96

ystem . . . S055 710 * 54 132 277 124 102 317 393 580 103

....... J220 674 38 237 133 175 60 31 267 407 542 108

....... S945 644 97 135 81 188 71 72 330 313 521 106

....... S910 628 * * 110 325 111 58 292 336 487 122

....... S210 581 * 72 160 227 65 39 321 260 432 128

....... S920 573 29 70 85 188 107 93 289 284 474 91

........... 17,646 1,830 2,656 3,424 5,710 2,207 1,804 8,161 9,485 14,328 2,900

Percent distribution

........... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

....... J225 6.6 2.7 4.2 8.3 8.3 6.7 4.7 4.4 8.3 6.8 5.4

....... J210 4.3 13.3 6.9 3.1 2.4 2.2 2.9 3.1 5.2 4.3 4.4

d ...... J505 3.9 8.5 5.5 3.7 2.7 2.7 3.1 3.6 4.2 3.9 4.3

....... S905 3.3 * 1.1 3.3 4.8 4.3 3.5 3.6 3.1 3.3 3.5

....... J570 3.1 2.1 4.2 3.8 3.3 2.6 1.1 2.4 3.7 3.2 2.8

....... S960 2.9 1.4 3.7 3.6 3.1 2.4 1.7 2.6 3.1 3.1 2.2

....... S900 2.6 * 1.1 3.6 3.7 3.1 0.9 3.1 2.3 2.5 3.2

....... J810 2.6 4.7 2.6 1.4 1.7 2.7 6.5 3.1 2.2 2.7 2.4

....... S925 2.2 * 1.8 2.6 2.5 2.5 2.4 2.2 2.2 2.1 2.2....... S930 2.1 * 2.1 3.0 2.4 1.9 1.2 2.3 2.0 2.3 1.5

....... J805 2.0 1.5 1.5 2.7 2.1 2.3 1.2 2.4 1.7 1.9 2.6

....... S940 2.0 * 1.5 1.9 2.2 2.4 3.2 2.0 2.0 2.0 1.9

....... S935 2.0 1.1 2.0 1.9 2.3 2.3 1.3 2.3 1.7 2.0 1.8

a ...... J205 1.9 4.9 2.9 1.4 1.1 1.6 2.5 1.4 2.3 2.0 1.6

ystem . . . S055 1.9 * 1.0 1.8 2.2 2.7 3.0 2.0 1.9 1.9 1.7

....... J220 1.8 1.1 4.3 1.8 1.4 1.3 0.9 1.6 2.0 1.8 1.8

....... S945 1.7 2.8 2.4 1.1 1.5 1.6 2.1 2.0 1.5 1.7 1.8

....... S910 1.7 * * 1.5 2.6 2.4 1.7 1.8 1.6 1.6 2.1

....... S210 1.6 * 1.3 2.2 1.8 1.4 1.1 2.0 1.3 1.4 2.2

....... S920 1.6 0.8 1.3 1.1 1.5 2.4 2.7 1.8 1.4 1.6 1.5

........... 48.0 52.3 48.0 46.2 46.2 48.6 52.3 50.3 46.2 47.8 49.0

cision. 1Based on ‘‘A Reason for Visit Classification for Ambulatory Care’’ (RVC) (10). 2Estimates for races other than white and black have been omitted because of small sample sizes.

ounding.

Series 13, No. 131 [ Page 51
nt distribution of injury-related emergency department visits by the 20 most frequent principal reasons for visit, according to hospital

–95

C code1 Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

Nonmetropolitan Voluntary, nonprofit Non-Federal government Proprietary

Number of visits in thousands

........... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

....... J225 2,429 530 706 680 513 1,877 552 1,639 234 556

....... J210 1,577 329 442 496 310 1,241 336 1,093 166 318

d ...... J505 1,448 286 434 472 256 1,223 226 1,001 160 287

....... S905 1,222 267 326 388 241 971 250 809 144 269

....... J570 1,149 257 347 364 181 909 240 808 88 253

....... S960 1,071 281 319 262 209 782 289 759 106 207

....... S900 974 207 282 294 191 824 150 693 93 188

....... J810 966 199 263 345 159 726 240 671 91 204

....... S925 796 193 244 205 154 621 175 552 71 173....... S930 783 172 266 209 136 590 194 534 82 168

....... J805 739 114 186 316 123 596 143 474 104 161

....... S940 737 151 234 232 120 566 170 528 68 141

....... S935 727 133 215 203 176 570 157 517 68 142

a ...... J205 711 167 163 236 146 574 137 471 64 176

ystem . . . S055 710 141 207 235 127 532 178 487 83 140

....... J220 674 124 148 268 134 490 184 443 61 170

....... S945 644 116 182 218 128 491 152 459 58 127

....... S910 628 122 150 217 138 478 150 411 65 151

....... S210 581 135 153 186 107 483 98 383 86 112

....... S920 573 108 186 171 108 425 148 403 75 94

........... 17,646 3,683 4,971 5,567 3,424 13,754 3,891 11,973 2,044 3,629

Percent distribution

........... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

....... J225 6.6 6.9 6.8 5.9 7.3 6.5 6.9 6.5 5.8 7.3

....... J210 4.3 4.3 4.2 4.3 4.4 4.3 4.2 4.4 4.1 4.1

d ...... J505 3.9 3.7 4.2 4.1 3.6 4.3 2.8 4.0 4.0 3.7

....... S905 3.3 3.5 3.1 3.4 3.4 3.4 3.1 3.2 3.6 3.5

....... J570 3.1 3.3 3.3 3.1 2.6 3.2 3.0 3.2 2.2 3.3

....... S960 2.9 3.6 3.1 2.3 3.0 2.7 3.6 3.0 2.6 2.7

....... S900 2.6 2.7 2.7 2.5 2.7 2.9 1.9 2.8 2.3 2.5

....... J810 2.6 2.6 2.5 3.0 2.2 2.5 3.0 2.7 2.3 2.7

....... S925 2.2 2.5 2.3 1.8 2.2 2.2 2.2 2.2 1.8 2.3....... S930 2.1 2.2 2.6 1.8 1.9 2.1 2.4 2.1 2.0 2.2

....... J805 2.0 1.5 1.8 2.7 1.7 2.1 1.8 1.9 2.6 2.1

....... S940 2.0 2.0 2.2 2.0 1.7 2.0 2.1 2.1 1.7 1.8

....... S935 2.0 1.7 2.1 1.8 2.5 2.0 2.0 2.1 1.7 1.9

a ...... J205 1.9 2.2 1.6 2.0 2.1 2.0 1.7 1.9 1.6 2.3

ystem . . . S055 1.9 1.8 2.0 2.0 1.8 1.9 2.2 1.9 2.1 1.8

....... J220 1.8 1.6 1.4 2.3 1.9 1.7 2.3 1.8 1.5 2.2

....... S945 1.7 1.5 1.7 1.9 1.8 1.7 1.9 1.8 1.5 1.7

....... S910 1.7 1.6 1.4 1.9 1.9 1.7 1.9 1.6 1.6 2.0

....... S210 1.6 1.7 1.5 1.6 1.5 1.7 1.2 1.5 2.1 1.5

....... S920 1.6 1.4 1.8 1.5 1.5 1.5 1.8 1.6 1.9 1.2

........... 48.0 47.8 47.7 48.1 48.4 47.9 48.3 47.7 51.0 47.3

mbulatory Care’’ (RVC) (10). NOTE: Number may not add to totals because of rounding.

Page 52 [ Series 13, No. 131
Table 33. Annual number and percent of emergency department injury visits by selected diagnostic services ordered or provided, according

to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95

Diagnostic service Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits ................... 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

No services ..................... 4,442 1,281 988 619 1,054 327 173 1,764 2,678 3,520 808

Blood pressure ................... 27,391 1,453 3,505 5,894 9,969 3,700 2,871 12,184 15,207 22,439 4,322

Extremity x ray ................... 11,640 530 2,048 2,541 3,846 1,417 1,257 5,329 6,311 9,782 1,612

Chest x ray ..................... 2,973 150 178 467 892 539 748 1,397 1,576 2,395 489

Urinalysis ...................... 2,664 91 210 582 931 382 469 1,344 1,320 2,080 510

Electrocardiogram ................. 1,816 25 34 165 506 394 692 966 850 1,490 283

HIV serology . . . . . . . . . . . . . . . . . . . . 114 * * 28 55 * * 70 44 88 *

Percent of injury visits

All injury visits . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ... ...

No services ..................... 12.1 36.6 17.8 8.4 8.5 7.2 5.0 10.9 13.0 11.7 13.7

Blood pressure ................... 74.5 41.5 63.3 79.5 80.7 81.4 83.3 75.0 74.0 74.8 73.1

Extremity x ray ................... 31.6 15.1 37.0 34.3 31.1 31.2 36.5 32.8 30.7 32.6 27.3

Chest x ray . . . . . . . . . . . . . . . . . . . . . 8.1 4.3 3.2 6.3 7.2 11.9 21.7 8.6 7.7 8.0 8.3

Urinalysis . . . . . . . . . . . . . . . . . . . . . . 7.2 2.6 3.8 7.8 7.5 8.4 13.6 8.3 6.4 6.9 8.6

Electrocardiogram . . . . . . . . . . . . . . . . . 4.9 0.7 0.6 2.2 4.1 8.7 20.1 5.9 4.1 5.0 4.8

HIV serology . . . . . . . . . . . . . . . . . . . . 0.3 * * 0.4 0.4 * * 0.4 0.2 0.3 *

Percent of emergency department visits that are injury related

All injury visits ................... 39.8 27.8 53.5 48.5 43.8 35.0 26.3 33.8 46.3 41.7 32.3

No services ..................... 35.6 24.9 46.3 47.7 44.9 35.3 27.3 29.6 41.1 38.1 28.0

Blood pressure ................... 40.3 32.5 54.7 48.3 43.3 34.6 25.9 34.0 47.4 42.1 33.2

Extremity x ray ................... 92.3 94.1 97.4 96.6 92.5 86.7 82.9 90.8 93.7 93.2 87.2

Chest x ray ..................... 19.7 9.9 25.7 37.7 27.1 17.3 14.3 17.9 21.8 19.8 18.2

Urinalysis ...................... 18.7 10.4 23.6 20.6 21.2 17.7 15.0 15.0 25.0 19.1 17.1

Electrocardiogram ................. 15.6 29.0 34.8 30.8 20.8 12.9 12.8 15.6 15.7 15.5 15.9

HIV serology .................... 40.8 * * 40.3 43.4 * * 45.3 35.3 44.8 *

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

1Estimates for races other than white and black have been omitted because of small sample sizes.

Series 13, No. 131 [ Page 53
Table 34. Annual number and percent of emergency department injury visits by selected diagnostic services ordered or provided, according

to hospital characteristics, averaged over a 4-year period: United States, 1992–95

Diagnostic service Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits ................... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

No services ..................... 4,442 851 1,183 1,535 873 3,239 1,203 2,875 486 1,080

Blood pressure ................... 27,391 5,907 7,861 8,270 5,353 21,782 5,609 18,862 2,995 5,534

Extremity x ray ................... 11,640 2,415 3,508 3,539 2,177 8,983 2,657 8,154 1,175 2,311

Chest x ray ..................... 2,973 571 851 1,075 476 2,332 641 1,987 374 611

Urinalysis ...................... 2,664 487 762 924 490 2,204 460 1,742 382 540

Electrocardiogram ................. 1,816 419 517 574 305 1,479 337 1,270 179 366

HIV serology . . . . . . . . . . . . . . . . . . . . 114 * * 58 * 101 * 75 * *

Percent of injury visits

All injury visits . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ...

No services ..................... 12.1 11.0 11.3 13.3 12.3 11.3 14.9 11.5 12.1 14.1

Blood pressure ................... 74.5 76.6 75.4 71.5 75.6 75.8 69.6 75.1 74.7 72.2

Extremity x ray ................... 31.6 31.3 33.6 30.6 30.7 31.3 33.0 32.5 29.3 30.1

Chest x ray . . . . . . . . . . . . . . . . . . . . . 8.1 7.4 8.2 9.3 6.7 8.1 7.9 7.9 9.3 8.0

Urinalysis . . . . . . . . . . . . . . . . . . . . . . 7.2 6.3 7.3 8.0 6.9 7.7 5.7 6.9 9.5 7.0

Electrocardiogram . . . . . . . . . . . . . . . . . 4.9 5.4 5.0 5.0 4.3 5.1 4.2 5.1 4.5 4.8

HIV serology . . . . . . . . . . . . . . . . . . . . 0.3 * * 0.5 * 0.4 * 0.3 * *

Percent of emergency department visits that are injury related

All injury visits ................... 39.8 40.8 40.8 37.6 40.8 39.9 39.5 40.8 34.4 39.8

No services ..................... 35.6 36.7 35.1 35.0 36.3 35.7 35.4 36.7 28.6 36.7

Blood pressure ................... 40.3 40.8 41.5 38.2 41.7 40.4 40.3 41.2 35.4 40.6

Extremity x ray ................... 92.3 91.5 92.6 91.7 93.8 92.0 93.6 92.3 91.0 91.8

Chest x ray ..................... 19.7 19.2 20.4 19.4 20.0 19.7 20.0 19.3 23.8 19.0

Urinalysis ...................... 18.7 18.2 19.3 18.7 18.3 18.9 17.6 18.6 19.6 18.3

Electrocardiogram ................. 15.6 15.6 16.1 15.5 15.3 16.0 14.0 16.0 16.1 14.2

HIV serology .................... 40.8 * * 49.8 * 39.8 * 41.4 * *

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

Page 54 [ Series 13, No. 131
Table 35. Annual number and percent of emergency department injury visits by selected therapeutic procedures provided, according to

patient age, sex, and race, averaged over a 4-year period: United States, 1992–95

Procedure Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits .............. 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

No procedures .............. 15,111 1,640 1,933 2,919 5,314 1,945 1,360 7,432 7,680 11,986 2,780

Wound care ............... 10,900 1,279 1,908 2,244 3,424 1,204 841 3,812 7,088 8,932 1,671

Orthopedic care ............. 7,427 277 1,418 1,667 2,472 886 707 3,406 4,021 6,373 908

Intravenous fluids ............ 2,633 98 168 434 872 468 593 1,147 1,486 2,166 400

Eye or ear/nose/throat care ...... 1,515 134 165 301 644 202 68 543 971 1,274 215

Bladder catheter . . . . . . . . . . . . . 457 * 14 82 128 57 167 246 211 384 68

NG tube . . . . . . . . . . . . . . . . . . 353 36 17 87 131 41 40 177 176 306 38

Endoctracheal tube . . . . . . . . . . . 120 * * 22 38 19 29 30 89 102 16

Cardiopulmonary resuscitation . . . . 54 * * * * * * * 42 46 *

Other procedure ............. 1,412 156 191 284 417 195 170 600 812 1,134 226

Percent of injury visits

All injury visits . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ... ...

No procedures .............. 41.1 46.9 34.9 39.4 43.0 42.8 39.4 45.8 37.4 40.0 47.0

Wound care ............... 29.6 36.5 34.5 30.3 27.7 26.5 24.4 23.5 34.5 29.8 28.3

Orthopedic care ............. 20.2 7.9 25.6 22.5 20.0 19.5 20.5 21.0 19.6 21.2 15.4

Intravenous fluids . . . . . . . . . . . . 7.2 2.8 3.0 5.9 7.1 10.3 17.2 7.1 7.2 7.2 6.8

Eye or ear/nose/throat care . . . . . . 4.1 3.8 3.0 4.1 5.2 4.4 2.0 3.3 4.7 4.2 3.6

Bladder catheter . . . . . . . . . . . . . 1.2 * 0.3 1.1 1.0 1.3 4.8 1.5 1.0 1.3 1.2

NG tube . . . . . . . . . . . . . . . . . . 1.0 1.0 0.3 1.2 1.1 0.9 1.2 1.1 0.9 1.0 0.6

Endoctracheal tube . . . . . . . . . . . 0.3 * * 0.3 0.3 0.4 0.9 0.2 0.4 0.3 0.3

Cardiopulmonary resuscitation . . . . 0.1 * * * * * * * 0.2 0.2 *

Other procedure . . . . . . . . . . . . . 3.8 4.4 3.5 3.8 3.4 4.3 4.9 3.7 4.0 3.8 3.8

Percent of emergency department visits that are injury related

All injury visits .............. 39.8 27.8 53.5 48.5 43.8 35.0 26.3 33.8 46.3 41.7 32.3

No procedures .............. 28.3 17.6 32.6 33.8 32.0 27.6 23.2 25.3 32.0 29.8 23.2

Wound care ............... 92.9 96.0 96.9 94.5 92.1 88.2 86.7 91.1 93.9 93.9 88.1

Orthopedic care ............. 95.0 95.2 98.9 96.4 94.4 90.8 92.3 93.9 96.1 95.5 91.5

Intravenous fluids ............ 19.6 18.6 34.7 30.2 24.4 16.4 12.9 16.1 23.5 19.8 18.6

Eye or ear/nose/throat care ...... 53.7 30.0 50.4 64.7 65.2 56.6 28.8 43.6 61.6 56.1 44.3

Bladder catheter ............. 20.8 * 39.7 25.9 27.8 19.7 16.7 17.5 26.7 21.2 19.5

NG tube .................. 47.4 75.9 89.8 73.3 63.3 33.6 17.6 46.2 48.6 48.2 42.6

Endoctracheal tube ........... 29.2 * * 73.3 54.3 22.7 14.9 17.2 38.2 29.4 27.7

Cardiopulmonary resuscitation .... 19.2 * * * * * * * 25.1 20.0 *

Other procedure ............. 26.0 23.0 43.1 31.6 29.7 21.8 31.7 20.2 33.0 27.4 22.0

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

1Estimates for races other than white and black have been omitted because of small sample sizes.

Series 13, No. 131 [ Page 55
Table 36. Annual number and percent of emergency department injury visits by selected therapeutic procedures provided, according to

hospital characteristics, averaged over a 4-year period: United States, 1992–95

Procedure Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits .............. 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

No procedures .............. 15,111 3,105 4,061 5,179 2,766 11,677 3,434 10,226 1,792 3,093

Wound care ............... 10,900 2,348 3,030 3,373 2,149 8,570 2,330 7,374 1,123 2,402

Orthopedic care ............. 7,427 1,593 2,324 2,043 1,466 5,864 1,563 5,192 648 1,587

Intravenous fluids ............ 2,633 483 797 805 547 2,155 478 1,775 395 464

Eye or ear/nose/throat care ...... 1,515 353 428 393 340 1,142 373 1,062 185 267

Bladder catheter . . . . . . . . . . . . . 457 63 126 176 91 390 66 285 78 94

NG tube . . . . . . . . . . . . . . . . . . 353 38 134 101 79 286 67 219 65 68

Endoctracheal tube . . . . . . . . . . . 120 * 39 37 * 93 * 70 * *

Cardiopulmonary resuscitation . . . . 54 * * 31 * 41 * * * *

Other procedure ............. 1,412 220 436 450 306 1,119 293 893 134 385

Percent of injury visits

All injury visits . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ...

No procedures .............. 41.1 40.3 38.9 44.8 39.1 40.7 42.6 40.7 44.7 40.4

Wound care ............... 29.6 30.4 29.1 29.2 30.4 29.8 28.9 29.4 28.0 31.3

Orthopedic care ............. 20.2 20.7 22.3 17.7 20.7 20.4 19.4 20.7 16.1 20.7

Intravenous fluids . . . . . . . . . . . . 7.2 6.3 7.6 7.0 7.7 7.5 5.9 7.1 9.8 6.0

Eye or ear/nose/throat care . . . . . . 4.1 4.6 4.1 3.4 4.8 4.0 4.6 4.2 4.6 3.5

Bladder catheter . . . . . . . . . . . . . 1.2 0.8 1.2 1.5 1.3 1.4 0.8 1.1 1.9 1.2

NG tube . . . . . . . . . . . . . . . . . . 1.0 0.5 1.3 0.9 1.1 1.0 0.8 0.9 1.6 0.9

Endoctracheal tube . . . . . . . . . . . 0.3 * 0.4 0.3 * 0.3 * 0.3 * *

Cardiopulmonary resuscitation . . . . 0.1 * * 0.3 * 0.1 * * * *

Other procedure . . . . . . . . . . . . . 3.8 2.9 4.2 3.9 4.3 3.9 3.6 3.6 3.3 5.0

Percent of emergency department visits that are injury related

All injury visits .............. 39.8 40.8 40.8 37.6 40.8 39.9 39.5 40.8 34.4 39.8

No procedures .............. 28.3 36.7 35.1 35.0 36.3 35.7 40.3 36.7 28.6 36.7

Wound care ............... 92.9 93.1 92.8 93.2 92.4 92.7 93.2 93.8 86.3 93.6

Orthopedic care ............. 95.0 94.7 94.9 95.4 95.1 94.9 95.6 95.4 93.9 94.3

Intravenous fluids ............ 19.6 18.4 19.7 19.9 20.1 19.6 19.3 19.3 24.4 17.5

Eye or ear/nose/throat care ...... 53.7 44.0 56.3 60.0 56.3 54.1 52.3 53.5 58.7 51.2

Bladder catheter ............. 20.8 21.8 20.0 21.5 20.1 21.7 16.7 19.4 31.0 19.9

NG tube .................. 47.4 36.3 51.1 49.9 45.5 46.6 51.0 44.3 59.7 49.1

Endoctracheal tube ........... 29.2 * 29.3 29.8 * 30.5 * 27.0 * *

Cardiopulmonary resuscitation .... 19.2 * * 25.0 * 19.7 * * * *

Other procedure ............. 26.0 25.5 26.8 26.8 24.3 25.4 28.5 26.2 22.9 27.0

* Figure does not meet standard of reliability or precision.

. . . Category not applicable.

0.0 Quantity more than zero less than 0.5.

Page 56 [ Series 13, No. 131
Table 37. Annual number and percent distribution of medications provided or prescribed in emergency department injury visits, according

to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95

Number of medications ordered Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits .............. 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

0 ...................... 12,007 1,730 2,360 2,421 3,348 1,145 1,004 5,169 6,839 9,779 1,909

1 ...................... 13,427 1,102 2,121 2,929 4,623 1,587 1,065 5,953 7,474 10,817 2,299

2 ...................... 6,791 470 769 1,347 2,608 972 625 2,991 3,800 5,565 1,079

3 ...................... 2,618 129 214 487 1,096 409 282 1,330 1,487 2,165 383

4 ...................... 1,083 42 59 164 410 231 177 529 554 938 133

5 or more . . . . . . . . . . . . . . . . . 751 26 11 60 233 181 239 397 354 631 103

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

0 ...................... 32.6 49.4 42.6 32.7 27.1 25.2 29.1 31.8 33.3 32.6 32.3

1 ...................... 36.5 31.5 38.3 39.5 37.4 34.9 30.9 36.7 36.4 36.1 38.9

2 ...................... 18.5 13.4 13.9 18.2 21.1 21.4 18.1 18.4 18.5 18.6 18.3

3 . . . . . . . . . . . . . . . . . . . . . . 7.1 3.7 3.9 6.6 8.9 9.0 8.2 8.2 7.2 7.2 6.5

4 . . . . . . . . . . . . . . . . . . . . . . 2.9 1.2 1.1 2.2 3.3 5.1 5.1 3.3 2.7 3.1 2.3

5 or more . . . . . . . . . . . . . . . . . 2.0 0.7 0.2 0.8 1.9 4.0 6.9 2.4 1.7 2.1 1.7

Percent of emergency department visits that are injury related

All injury visits .............. 39.8 27.8 53.5 49.0 43.8 35.0 26.3 33.8 46.3 41.7 32.3

0 ...................... 47.0 47.4 69.0 52.9 47.5 37.8 26.4 40.4 53.7 49.5 37.2

1 ...................... 45.1 23.7 55.7 53.9 50.2 41.8 31.7 39.0 51.6 47.3 37.3

2 ...................... 34.1 15.4 38.4 41.7 39.8 34.9 27.3 28.3 40.6 35.8 27.8

3 ...................... 28.4 10.6 27.1 37.3 35.8 26.9 21.1 23.0 34.5 30.4 20.6

4 ...................... 26.8 11.6 26.6 33.7 31.8 26.7 21.7 23.8 30.6 28.7 20.5

5 or more ................. 22.2 18.1 11.3 26.8 26.5 21.8 19.8 20.0 25.2 23.0 18.1

1Estimates for races other than white and black have been omitted because of small sample sizes.

Table 38. Annual number and percent distribution of medications provided or prescribed in emergency department injury visits, according

to hospital characteristics, averaged over a 4-year period: United States, 1992–95

Number of medications ordered Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits .............. 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

0 ...................... 12,007 2,629 3,188 3,712 2,478 9,218 2,789 8,250 1,287 2,470

1 ...................... 13,427 3,019 3,945 4,077 2,386 10,688 2,739 9,303 1,389 2,736

2 ...................... 6,791 1,291 1,945 2,291 1,265 5,319 1,472 4,570 770 1,451

3 ...................... 2,618 434 788 875 520 2,050 568 1,723 307 588

4 ...................... 1,083 195 306 348 234 812 271 699 144 240

5 or more . . . . . . . . . . . . . . . . . 860 144 255 262 199 636 224 563 115 182

Percent distribution

All injury visits .............. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

0 ...................... 32.6 34.1 30.6 32.1 35.0 32.1 34.6 32.9 32.1 32.2

1 ...................... 36.5 39.1 37.8 35.3 33.7 37.2 34.0 37.0 34.6 35.7

2 ...................... 18.5 16.7 18.7 19.8 17.9 18.5 18.3 18.2 19.2 18.9

3 . . . . . . . . . . . . . . . . . . . . . . 7.1 5.6 7.6 7.6 7.3 7.1 7.0 6.9 7.6 7.7

4 . . . . . . . . . . . . . . . . . . . . . . 2.9 2.5 2.9 3.0 3.3 2.8 3.4 2.8 3.6 3.1

5 or more . . . . . . . . . . . . . . . . . 2.3 1.9 2.4 2.3 2.8 2.2 2.8 2.2 2.9 2.4

Percent of emergency department visits that are injury related

All injury visits .............. 39.8 40.8 40.8 37.6 40.8 39.9 39.5 40.8 34.4 39.8

0 ...................... 47.0 47.6 46.9 44.6 50.5 46.7 48.1 48.4 38.6 48.0

1 ...................... 45.1 45.9 46.7 42.5 46.5 45.9 42.5 46.1 38.9 45.8

2 ...................... 34.1 34.1 34.8 33.7 33.8 34.3 33.2 34.4 31.6 34.7

3 ...................... 28.4 27.2 30.9 26.9 28.4 27.8 30.7 29.0 25.6 28.2

4 ...................... 26.8 28.3 28.4 34.7 27.1 26.0 29.5 27.3 26.1 26.1

5 or more ................. 22.2 21.0 24.3 20.1 23.7 21.8 23.3 23.3 21.4 19.9

Series 13, No. 131 [ Page 57
Table 39. Annual number, percent distribution, and rate of drug mentions at emergency department injury visits by therapeutic class,

according to patient age, sex, and race, averaged over a 4-year period: United States, 1992–95

Therapeutic classification1 Total

Patient age Sex Race3

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of mentions in thousands

All mentions .................. 43,491 2,732 4,595 8,051 16,076 6,692 5,344 19,780 23,711 35,861 6,684

Anesthetic drugs . . . . . . . . . . . . . . . . 848 95 104 156 250 114 129 288 560 749 77

Antidotes . . . . . . . . . . . . . . . . . . . . 255 39 * 56 100 32 * 146 109 208 40

Antimicrobial agents . . . . . . . . . . . . . 5,112 565 761 1,001 1,740 651 394 1,901 3,211 4,076 920

Hemotologic agents . . . . . . . . . . . . . . 248 * * 24 52 54 99 107 141 211 35

Cardiovascular-renal drugs ......... 1,396 * * 39 204 334 783 832 564 1,186 175

Psychopharmacologic drugs ........ 1,698 81 115 213 681 318 290 894 804 1,482 186

Gastrointestinal agents . . . . . . . . . . . . 914 47 40 139 302 181 205 504 410 756 136

Metabolic and nutrient agents . . . . . . . 624 30 * 65 183 150 173 295 329 519 85

Hormones and agents affecting

hormonal mechanisms ........... 1,218 104 113 147 343 280 231 724 495 1,048 143

Immunologic agent .............. 3,676 37 274 798 1,452 626 490 1,418 2,258 3,050 529

Skin/mucous membrane ........... 2,521 316 451 505 829 254 167 920 1,601 2,088 378

Neurologic drugs ............... 1,707 * 26 311 932 297 126 856 851 1,394 275

Ophthalmic drugs ............... 1,315 107 187 268 527 161 64 437 878 1,118 176

Drugs used for relief of pain ........ 17,545 789 1,964 3,644 6,985 2,548 1,614 8,200 9,345 14,359 2,830

Respiratory tract drugs ............ 2,602 323 320 427 904 358 270 1,354 1,247 2,122 423

Other and unclassified2 ........... 1,813 151 178 259 593 335 296 903 910 1,495 276

Percent distribution

All mentions .................. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Anesthetic drugs . . . . . . . . . . . . . . . . 1.9 3.5 2.3 1.9 1.6 1.7 2.4 1.5 2.4 2.1 1.1

Antidotes . . . . . . . . . . . . . . . . . . . . 0.6 1.4 * 0.7 0.6 0.5 * 0.7 0.5 0.6 0.6

Antimicrobial agents . . . . . . . . . . . . . 11.8 20.7 16.6 12.4 10.8 9.7 7.4 9.6 13.5 11.4 13.8

Hemotologic agents . . . . . . . . . . . . . . 0.6 * * 0.3 0.3 0.8 1.8 0.5 0.6 0.6 0.5

Cardiovascular-renal drugs . . . . . . . . . 3.2 * * 0.5 1.3 5.0 14.7 4.2 2.4 3.3 2.6

Psychopharmacologic drugs . . . . . . . . 3.9 3.0 2.5 2.6 4.2 4.7 5.4 4.5 3.4 4.1 2.8

Gastrointestinal agents . . . . . . . . . . . . 2.1 1.7 0.9 1.7 1.9 2.7 3.8 2.5 1.7 2.1 2.0

Metabolic and nutrient agents . . . . . . . 1.4 1.1 * 0.8 1.1 2.2 3.2 1.5 1.4 1.4 1.3

Hormones and agents affecting

hormonal mechanisms . . . . . . . . . . 2.8 3.8 2.5 1.8 2.1 4.2 4.3 3.7 2.1 2.9 2.1

Immunologic agent . . . . . . . . . . . . . . 8.5 1.3 6.0 9.9 9.0 9.3 9.2 7.2 9.5 8.5 7.9

Skin/mucous membrane . . . . . . . . . . . 5.8 11.6 9.8 6.3 5.2 3.8 3.1 4.7 6.8 5.8 5.7

Neurologic drugs . . . . . . . . . . . . . . . 3.9 * 0.6 3.9 5.8 4.4 2.4 4.3 3.6 3.9 4.1

Ophthalmic drugs . . . . . . . . . . . . . . . 3.0 3.9 4.1 3.3 3.3 2.4 1.2 2.2 3.7 3.1 2.6

Drugs used for relief of pain ........ 40.3 28.9 42.7 45.3 43.5 38.1 30.2 41.5 39.4 40.0 42.3

Respiratory tract drugs . . . . . . . . . . . . 6.0 11.8 7.0 5.3 5.6 5.3 5.0 6.8 5.3 5.9 6.3

Other and unclassified2 . . . . . . . . . . . 4.2 5.5 3.9 3.2 3.7 5.0 5.5 4.6 3.8 4.2 4.1

Number of drugs per 100 injury visits

All mentions .................. 118.2 78.1 83.0 108.7 130.2 147.2 155.0 121.8 115.4 119.5 113.1

Anesthetic drugs . . . . . . . . . . . . . . . . 2.3 2.7 1.9 2.1 2.0 2.5 3.7 1.8 2.7 2.5 1.3

Antidotes . . . . . . . . . . . . . . . . . . . . 0.7 1.1 0.0 0.8 0.8 0.7 * 0.9 0.5 0.7 0.7

Antimicrobial agents ............. 13.9 16.1 13.7 13.5 14.1 14.3 11.4 11.7 15.6 13.6 15.6

Hemotologic agents . . . . . . . . . . . . . . 0.7 * * 0.3 0.4 1.2 2.9 0.7 0.7 0.7 0.6

Cardiovascular-renal drugs . . . . . . . . . 3.8 * * 0.5 1.7 7.4 22.7 5.1 2.7 4.0 3.0

Psychopharmacologic drugs . . . . . . . . 4.6 2.3 2.1 2.9 5.5 7.0 8.4 5.5 3.9 4.9 3.1

Gastrointestinal agents . . . . . . . . . . . . 2.5 1.3 0.7 1.9 2.4 4.0 5.9 3.1 2.0 2.5 2.3

Metabolic and nutrient agents . . . . . . . 1.7 0.9 * 0.9 1.5 3.3 5.0 1.8 1.6 1.7 1.4

Hormones and agents affecting

hormonal mechanisms . . . . . . . . . . . 3.3 3.0 2.1 2.0 2.8 6.2 6.7 4.5 2.4 3.5 2.4

Immunologic agent .............. 10.0 1.1 4.9 10.8 11.8 13.8 14.2 8.7 11.0 10.2 9.0

Skin/mucous membrane . . . . . . . . . . . 6.9 9.0 8.1 6.8 6.7 5.6 4.8 5.7 7.8 7.0 6.4

Neurologic drugs . . . . . . . . . . . . . . . 4.6 * 0.5 4.2 7.5 6.5 3.6 5.3 4.1 4.6 4.7

Ophthalmic drugs . . . . . . . . . . . . . . . 3.6 3.1 3.4 3.6 4.3 3.5 1.8 2.7 4.3 3.7 3.0

Drugs used for relief of pain ........ 47.7 22.6 35.5 49.2 56.6 56.0 46.8 50.5 45.5 47.9 47.9

Respiratory tract drugs . . . . . . . . . . . . 7.1 9.2 5.8 5.8 7.3 7.9 7.8 8.3 6.1 7.1 7.2

Other and unclassified2 . . . . . . . . . . . 4.9 4.3 3.2 3.5 4.8 7.4 8.6 5.6 4.4 5.0 4.7

* Figure does not meet standard of reliability or precision. 0.0 Quantity is more than zero but less than 0.5.

1Based on the standard drug classification used in the National Drug Code Directory, 1985 edition (NDC) (4). 2Includes radiopharmaceutical/contrast media, oncolytics, otologic drugs, antiparasitic agents, and unclassified/miscellaneous drugs.

3Estimates for races other than white and black have been omitted because of small sample sizes.

NOTE: Numbers may not add to totals because of rounding.

Page 58 [ Series 13, No. 131
Table 40. Annual number, percent distribution, and rate of drug mentions at emergency department injury visits by therapeutic class,

according to hospital characteristics, averaged over a 4-year period: United States, 1992–95

Therapeutic classification1 Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of mentions in thousands

All mentions .................... 43,491 8,406 12,697 13,985 8,404 33,905 9,586 29,227 4,996 9,268

Anesthetic drugs . . . . . . . . . . . . . . . . . . 848 118 289 212 228 657 190 552 125 170

Antidotes . . . . . . . . . . . . . . . . . . . . . . 255 28 109 58 60 208 47 172 35 48

Antimicrobial agents . . . . . . . . . . . . . . . 5,112 1,045 1,590 1,635 841 4,063 1,048 3,412 583 1,117

Hemotologic agents . . . . . . . . . . . . . . . . 248 64 56 84 44 191 58 158 41 49

Cardiovascular-renal drugs ........... 1,396 316 432 379 269 1,011 385 934 175 286

Psychopharmacologic drugs .......... 1,698 366 487 459 386 1,329 369 1,123 219 356

Gastrointestinal agents . . . . . . . . . . . . . . 914 187 255 272 200 701 213 598 141 175

Metabolic and nutrient agents . . . . . . . . . 624 96 202 171 156 457 167 433 92 99

Hormones and agents affecting hormonal

mechanisms ................... 1,218 278 362 330 249 945 273 821 121 277

Immunologic agent ................ 3,676 800 979 1,172 726 2,855 821 2,466 393 817

Skin/mucous membrane ............. 2,521 456 757 872 436 1,871 650 1,684 247 590

Neurologic drugs ................. 1,707 268 488 634 316 1,359 348 1,135 183 359

Ophthalmic drugs ................. 1,315 233 443 397 241 987 328 932 150 233

Drugs used for relief of pain .......... 17,545 3,365 5,097 5,692 3,391 13,838 3,707 11,832 1,989 3,725

Respiratory tract drugs .............. 2,602 485 654 950 513 2,044 558 1,743 300 559

Other and unclassified2 ............. 1,813 300 496 668 349 1,391 422 1,232 203 409

Percent distribution

All mentions .................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Anesthetic drugs . . . . . . . . . . . . . . . . . . 1.9 1.4 2.3 1.5 2.7 1.9 2.0 1.9 2.5 1.8

Antidotes . . . . . . . . . . . . . . . . . . . . . . 0.6 0.3 0.9 0.4 0.7 0.6 0.5 0.6 0.7 0.5

Antimicrobial agents . . . . . . . . . . . . . . . 11.8 12.4 12.5 11.7 10.0 12.0 10.9 11.7 11.7 12.0

Hemotologic agents . . . . . . . . . . . . . . . . 0.6 0.8 0.4 0.6 0.5 0.6 0.6 0.5 0.8 0.5

Cardiovascular-renal drugs . . . . . . . . . . . 3.2 3.8 3.4 2.7 3.2 3.0 4.0 3.2 3.5 3.1

Psychopharmacologic drugs . . . . . . . . . . 3.9 4.4 3.8 3.3 4.6 3.9 3.8 3.8 4.4 3.8

Gastrointestinal agents . . . . . . . . . . . . . . 2.1 2.2 2.0 1.9 2.4 2.1 2.2 2.0 2.8 1.9

Metabolic and nutrient agents . . . . . . . . . 1.4 1.1 1.6 1.2 1.9 1.3 1.7 1.5 1.8 1.1

Hormones and agents affecting hormonal

mechanisms . . . . . . . . . . . . . . . . . . . 2.8 3.3 2.9 2.4 3.0 2.8 2.9 2.8 2.4 3.0

Immunologic agent . . . . . . . . . . . . . . . . 8.5 9.5 7.7 8.4 8.6 8.4 8.6 8.4 7.9 8.8

Skin/mucous membrane . . . . . . . . . . . . . 5.8 5.4 6.0 6.2 5.2 5.5 6.8 5.8 5.0 6.4

Neurologic drugs . . . . . . . . . . . . . . . . . 3.9 3.2 3.8 4.5 3.8 4.0 3.6 3.9 3.7 3.9

Ophthalmic drugs . . . . . . . . . . . . . . . . . 3.0 2.8 3.5 2.8 2.9 2.9 3.4 3.2 3.0 2.5

Drugs used for relief of pain .......... 40.3 40.0 40.1 40.7 40.4 40.8 38.7 40.5 39.8 40.2

Respiratory tract drugs . . . . . . . . . . . . . . 6.0 5.8 5.1 6.8 6.1 6.0 5.8 6.0 6.0 6.0

Other and unclassified2 . . . . . . . . . . . . . 4.2 3.6 3.9 4.8 4.2 4.1 4.4 4.2 4.1 4.4

Number of drugs per 100 injury visits

All mentions .................... 118.2 109.0 121.8 120.9 118.7 118.0 118.9 116.4 124.6 120.9

Anesthetic drugs . . . . . . . . . . . . . . . . . . 2.3 1.5 2.8 1.8 3.2 2.3 2.4 2.2 3.1 2.2

Antidotes . . . . . . . . . . . . . . . . . . . . . . 0.7 0.4 1.0 0.5 0.8 0.7 0.6 0.7 0.9 0.6

Antimicrobial agents ............... 13.9 13.5 15.3 14.1 11.9 14.1 13.0 13.6 14.5 14.6

Hemotologic agents . . . . . . . . . . . . . . . . 0.7 0.8 0.5 0.7 0.6 0.7 0.7 0.6 1.0 0.6

Cardiovascular-renal drugs . . . . . . . . . . . 3.8 4.1 4.1 3.3 3.8 3.5 4.8 3.7 4.4 3.7

Psychopharmacologic drugs . . . . . . . . . . 4.6 4.7 4.7 4.0 5.5 4.6 4.6 4.5 5.5 4.6

Gastrointestinal agents . . . . . . . . . . . . . . 2.5 2.4 2.4 2.3 2.8 2.4 2.6 2.4 3.5 2.3

Metabolic and nutrient agents . . . . . . . . . 1.7 1.2 1.9 1.5 2.2 1.6 2.1 1.7 2.3 1.3

Hormones and agents affecting hormonal

mechanisms . . . . . . . . . . . . . . . . . . . 3.3 3.6 3.5 2.9 3.5 3.3 3.4 3.3 3.0 3.6

Immunologic agent ................ 10.0 10.4 9.4 10.1 10.3 9.9 10.2 9.8 9.8 10.7

Skin/mucous membrane . . . . . . . . . . . . . 6.9 5.9 7.3 7.5 6.2 6.5 8.1 6.7 6.2 7.7

Neurologic drugs . . . . . . . . . . . . . . . . . 4.6 3.5 4.7 5.5 4.5 4.7 4.3 4.5 4.6 4.7

Ophthalmic drugs . . . . . . . . . . . . . . . . . 3.6 3.0 4.3 3.4 3.4 3.4 4.1 3.7 3.7 3.0

Drugs used for relief of pain .......... 47.7 43.6 48.9 49.2 47.9 48.2 46.0 47.1 49.6 48.6

Respiratory tract drugs . . . . . . . . . . . . . . 7.1 6.3 6.3 8.2 7.2 7.1 6.9 6.9 7.5 7.3

Other and unclassified2 . . . . . . . . . . . . . 4.9 3.9 4.8 5.8 4.9 4.8 5.2 4.9 5.1 5.3

1Based on the standard drug classification used in the National Drug Code Directory, 1985 edition (NDC) (4). 2Includes radiopharmaceutical/contrast media, oncolytics, otologic drugs, antiparasitic agents, and unclassified/miscellaneous drugs.

NOTE: Numbers may not add to totals because of rounding.

Series 13, No. 131 [ Page 59
Table 41. Annual number and percent distribution of medications by the 20 drug entry names most frequently recorded at emergency

department injury visits, according to patient’s age, sex, and race, averaged over a 4-year period: United States, 1992–95

Entry name of drug1 Total

Patient age Sex Race2

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All drug mentions ................. 43,491 2,732 4,595 8,051 16,076 6,692 5,344 19,780 23,711 35,861 6,684

Tylenol ........................ 3,122 469 773 621 734 267 258 1,459 1,663 2,483 555

Motrin ........................ 2,424 37 155 328 1,130 334 140 1,068 1,356 1,799 564

Toradol ....................... 1,560 * * 294 739 314 184 771 790 1,238 305

Tylenol with codeine ............... 1,393 * 144 296 597 207 131 569 824 1,174 183

Diptheria tetanus toxoids pertussis ...... 1,294 * 73 286 517 245 168 494 800 1,127 141

Vicodin ....................... 1,270 * 27 291 594 249 97 564 705 1,126 115

Advil ......................... 1,121 * 267 324 378 89 47 519 602 929 176

Tetanus toxoid ................... 1,037 * 92 214 399 176 145 383 654 789 210

Keflex . . . . . . . . . . . . . . . . . . . . . . . . 983 41 155 195 385 143 65 326 657 776 175

Benadryl . . . . . . . . . . . . . . . . . . . . . . . 900 137 130 146 318 109 59 499 400 701 174

Ibuprofen . . . . . . . . . . . . . . . . . . . . . . 888 17 110 227 379 127 28 417 471 721 149

Tetanus diptheria toxoid . . . . . . . . . . . . . 852 * 67 191 350 138 102 331 521 719 116

Darvocet-n . . . . . . . . . . . . . . . . . . . . . 797 * 28 152 321 147 145 461 336 687 102

Lidocaine . . . . . . . . . . . . . . . . . . . . . . 747 89 153 148 215 75 66 262 485 636 100

Flexeril . . . . . . . . . . . . . . . . . . . . . . . . 702 * * 141 402 121 25 347 355 591 98

Neosporin . . . . . . . . . . . . . . . . . . . . . . 658 85 140 135 196 66 36 222 437 547 101

Phenergan . . . . . . . . . . . . . . . . . . . . . 653 43 72 92 230 111 105 303 350 577 70

Xylocaine . . . . . . . . . . . . . . . . . . . . . . 558 57 118 123 169 52 38 290 268 476 65

Bacitracin . . . . . . . . . . . . . . . . . . . . . . 543 107 105 102 151 55 24 184 359 448 89

Depo-provera . . . . . . . . . . . . . . . . . . . 509 29 54 56 181 91 98 254 255 453 49

All other mentions ................. 21,479 1,538 1,905 3,688 7,691 3,575 3,382 10,310 11,678 17,863 3,147

Percent distribution

All drug mentions ................. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Tylenol . . . . . . . . . . . . . . . . . . . . . . . . 7.2 17.2 16.8 7.7 4.6 4.0 4.8 7.4 7.0 6.9 8.3

Motrin . . . . . . . . . . . . . . . . . . . . . . . . 5.6 1.4 3.4 4.1 7.0 5.0 2.6 5.4 5.7 5.0 8.4

Toradol . . . . . . . . . . . . . . . . . . . . . . . 3.6 * * 3.7 4.6 4.7 3.4 3.9 3.3 3.5 4.6

Tylenol with codeine . . . . . . . . . . . . . . . 3.2 * 3.1 3.7 3.7 3.1 2.4 2.9 3.5 3.3 2.7

Diptheria tetanus toxoids pertussis . . . . . . 3.0 * 1.6 3.6 3.2 3.7 3.1 2.5 3.4 3.1 2.1

Vicodin . . . . . . . . . . . . . . . . . . . . . . . 2.9 * 0.6 3.6 3.7 3.7 1.8 2.9 3.0 3.1 1.7

Advil . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 * 5.8 4.0 2.4 1.3 0.9 2.6 2.5 2.6 2.6

Tetanus toxoid . . . . . . . . . . . . . . . . . . . 2.4 * 2.0 2.7 2.5 2.6 2.7 1.9 2.8 2.2 3.1

Keflex . . . . . . . . . . . . . . . . . . . . . . . . 2.3 1.5 3.4 2.4 2.4 2.1 1.2 1.6 2.8 2.2 2.6

Benadryl . . . . . . . . . . . . . . . . . . . . . . . 2.1 5.0 2.8 1.8 2.0 1.6 1.1 2.5 1.7 2.0 2.6

Ibuprofen . . . . . . . . . . . . . . . . . . . . . . 2.0 0.6 2.4 2.8 2.4 1.9 0.5 2.1 2.0 2.0 2.2

Tetanus diptheria toxoid . . . . . . . . . . . . . 2.0 * 1.4 2.4 2.2 2.1 1.9 1.7 2.2 2.0 1.7

Darvocet-n . . . . . . . . . . . . . . . . . . . . . 1.8 * 0.6 1.9 2.0 2.2 2.7 2.3 1.4 1.9 1.5

Lidocaine . . . . . . . . . . . . . . . . . . . . . . 1.7 3.3 3.3 1.8 1.3 1.1 1.2 1.3 2.0 1.8 1.5

Flexeril . . . . . . . . . . . . . . . . . . . . . . . . 1.6 * * 1.8 2.5 1.8 0.5 1.8 1.5 1.6 1.5

Neosporin . . . . . . . . . . . . . . . . . . . . . . 1.5 3.1 3.1 1.7 1.2 1.0 0.7 1.1 1.8 1.5 1.5

Phenergan . . . . . . . . . . . . . . . . . . . . . 1.5 1.6 1.6 1.1 1.4 1.7 2.0 1.5 1.5 1.6 1.1

Xylocaine . . . . . . . . . . . . . . . . . . . . . . 1.3 2.1 2.6 1.5 1.0 0.8 0.7 1.5 1.1 1.3 1.0

Bacitracin . . . . . . . . . . . . . . . . . . . . . . 1.2 3.9 2.3 1.3 0.9 0.8 0.4 0.9 1.5 1.3 1.3

Depo-provera . . . . . . . . . . . . . . . . . . . 1.2 1.1 1.2 0.7 1.1 1.4 1.8 1.3 1.1 1.3 0.7

All other mentions ................. 49.4 56.3 41.4 45.8 47.8 53.4 63.3 52.1 49.3 49.8 47.1

* Figure does not meet standard of reliability or precision.

1The entry made by the hospital staff on the prescription or other medical records. This may be a trade name, generic name, or desired therapeutic effect. 2Estimates for races other than white and black have been omitted because of small sample sizes.

Page 60 [ Series 13, No. 131
Table 42. Annual number and percent distribution of medications by the 20 drug entry names most frequently recorded at emergency

department injury visits, according to hospital characteristics, averaged over a 4-year period: United States, 1992–95

Entry name of drug1 Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of mentions in thousands

All drug mentions ................. 43,491 8,406 12,697 13,985 8,404 33,905 9,586 29,227 4,996 9,268

Tylenol ........................ 3,122 791 1,038 819 474 2,516 606 2,146 293 684

Motrin ........................ 2,424 592 787 652 393 2,031 393 1,636 373 415

Toradol ....................... 1,560 250 448 630 233 1,221 340 1,036 165 359

Tylenol with codeine ............... 1,393 210 476 367 340 1,094 299 935 202 256

Diptheria tetanus toxoids pertussis ...... 1,294 163 435 334 362 1,004 290 866 168 259

Vicodin ....................... 1,270 101 269 379 520 1,037 233 786 169 314

Advil ......................... 1,121 310 283 362 166 893 228 763 231 128

Tetanus toxoid ................... 1,037 303 188 406 141 822 216 615 132 290

Keflex . . . . . . . . . . . . . . . . . . . . . . . . 983 236 250 323 174 764 219 660 103 221

Benadryl . . . . . . . . . . . . . . . . . . . . . . . 900 224 223 289 163 711 188 607 115 178

Ibuprofen . . . . . . . . . . . . . . . . . . . . . . 888 179 296 213 200 625 263 632 97 158

Tetanus diptheria toxoid . . . . . . . . . . . . . 852 211 202 310 130 648 205 650 65 137

Darvocet-n . . . . . . . . . . . . . . . . . . . . . 797 100 267 366 64 555 243 575 39 184

Lidocaine . . . . . . . . . . . . . . . . . . . . . . 747 143 275 185 144 532 215 528 83 136

Flexeril . . . . . . . . . . . . . . . . . . . . . . . . 702 120 197 280 105 553 149 497 54 151

Neosporin . . . . . . . . . . . . . . . . . . . . . . 658 63 176 340 79 490 168 409 79 171

Phenergan . . . . . . . . . . . . . . . . . . . . . 653 29 116 357 151 486 167 390 91 172

Xylocaine . . . . . . . . . . . . . . . . . . . . . . 558 71 176 216 95 417 141 371 33 154

Bacitracin . . . . . . . . . . . . . . . . . . . . . . 543 196 254 67 26 442 101 420 30 93

Depo-provera . . . . . . . . . . . . . . . . . . . 509 71 146 174 117 397 112 331 54 124

All other mentions ................. 21,479 4,042 6,193 6,916 4,328 112 4,812 14,376 2,420 4,683

Percent distribution

All drug mentions ................. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Tylenol . . . . . . . . . . . . . . . . . . . . . . . . 7.2 9.4 8.2 5.9 5.6 7.4 6.3 7.3 5.9 7.4

Motrin . . . . . . . . . . . . . . . . . . . . . . . . 5.6 7.0 6.2 4.7 4.7 6.0 4.1 5.6 7.5 4.5

Toradol . . . . . . . . . . . . . . . . . . . . . . . 3.6 3.0 3.5 4.5 2.8 3.6 3.5 3.5 3.3 3.9

Tylenol with codeine . . . . . . . . . . . . . . . 3.2 2.5 3.7 2.6 4.0 3.2 3.1 3.2 4.0 2.8

Diptheria tetanus toxoids pertussis . . . . . . 3.0 1.9 3.4 2.4 4.3 3.0 3.0 3.0 3.4 2.8

Vicodin . . . . . . . . . . . . . . . . . . . . . . . 2.9 1.2 2.1 2.7 6.2 3.1 2.4 2.7 3.4 3.4

Advil . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 3.7 2.2 2.6 2.0 2.6 2.4 2.6 4.6 1.4

Tetanus toxoid . . . . . . . . . . . . . . . . . . . 2.4 3.6 1.5 2.9 1.7 2.4 2.2 2.1 2.6 3.1

Keflex . . . . . . . . . . . . . . . . . . . . . . . . 2.3 2.8 2.0 2.3 2.1 2.3 2.3 2.3 2.1 2.4

Benadryl . . . . . . . . . . . . . . . . . . . . . . . 2.1 2.7 1.8 2.1 1.9 2.1 2.0 2.1 2.3 1.9

Ibuprofen . . . . . . . . . . . . . . . . . . . . . . 2.0 2.1 2.3 1.5 2.4 1.8 2.7 2.2 1.9 1.7

Tetanus diptheria toxoid . . . . . . . . . . . . . 2.0 2.5 1.6 2.2 1.5 1.9 2.1 2.2 1.3 1.5

Darvocet-n . . . . . . . . . . . . . . . . . . . . . 1.8 1.2 2.1 2.6 0.8 1.6 2.5 2.0 0.8 2.0

Lidocaine . . . . . . . . . . . . . . . . . . . . . . 1.7 1.7 2.2 1.3 1.7 1.6 2.2 1.8 1.7 1.5

Flexeril . . . . . . . . . . . . . . . . . . . . . . . . 1.6 1.4 1.6 2.0 1.2 1.6 1.6 1.7 1.1 1.6

Neosporin . . . . . . . . . . . . . . . . . . . . . . 1.5 0.8 1.4 2.4 0.9 1.4 1.8 1.4 1.6 1.8

Phenergan . . . . . . . . . . . . . . . . . . . . . 1.5 0.3 0.9 2.6 1.8 1.4 1.7 1.3 1.8 1.9

Xylocaine . . . . . . . . . . . . . . . . . . . . . . 1.3 0.8 1.4 1.5 1.1 1.2 1.5 1.3 0.7 1.7

Bacitracin . . . . . . . . . . . . . . . . . . . . . . 1.2 2.3 2.0 0.5 0.3 1.3 1.1 1.4 0.6 1.0

Depo-provera . . . . . . . . . . . . . . . . . . . 1.2 0.9 1.2 1.2 1.4 1.2 1.2 1.1 1.1 1.3

All other mentions ................. 49.4 48.1 48.8 49.5 51.5 0.3 50.2 49.2 48.4 50.5

1The entry made by the hospital staff on the prescription or other medical records. This may be a trade name, generic name, or desired therapeutic effect.

Series 13, No. 131 [ Page 61
Table 43. Annual number and percent of emergency department visits by providers seen, according to patient age, sex, and race, averaged

over a 4-year period: United States, 1992–95

Provider seen Total

Patient age Sex Race1

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits ................... 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Staff physician ................... 31,114 2,876 4,677 6,246 10,443 3,909 2,963 13,786 17,328 25,547 4,815

Registered nurse ................. 31,066 2,920 4,624 6,272 10,456 3,851 2,944 13,812 17,254 25,522 4,798

Resident/intern ................... 4,221 460 621 840 1,490 475 334 1,896 2,325 2,860 1,248

Other physician .................. 3,905 352 529 772 1,222 506 523 1,661 2,244 3,312 522

Licensed practical nurse ............. 2,135 207 355 426 707 257 184 942 1,193 1,725 388

Physician assistant ................ 1,302 101 180 268 492 159 103 531 771 1,051 230

Nurse practitioner ................. 1,069 71 137 231 421 133 77 453 617 836 212

Percent of injury visits

All injury visits . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ... ...

Staff physician ................... 84.6 82.2 84.5 84.3 84.6 86.0 85.9 84.9 84.3 85.2 81.4

Registered nurse ................. 84.5 83.4 83.5 84.6 84.7 84.7 85.4 85.1 84.0 85.1 81.2

Resident/intern . . . . . . . . . . . . . . . . . . . 11.5 13.1 11.2 11.3 12.1 10.5 9.7 11.7 11.3 9.5 21.1

Other physician .................. 10.6 10.1 9.6 10.4 9.9 11.1 15.2 10.2 10.9 11.0 8.8

Licensed practical nurse . . . . . . . . . . . . . 5.8 5.9 6.4 5.7 5.7 5.7 5.3 5.8 5.8 5.8 6.6

Physician assistant . . . . . . . . . . . . . . . . 3.5 2.9 3.2 3.6 4.0 3.5 3.0 3.3 3.8 3.5 3.9

Nurse practitioner . . . . . . . . . . . . . . . . . 2.9 2.0 2.5 3.1 3.4 2.9 2.2 2.8 3.0 2.8 3.6

Percent of emergency department visits that are injury related

All injury visits ................... 39.8 27.8 53.5 48.5 43.8 35.0 26.3 33.8 46.3 41.7 32.3

Staff physician ................... 36.9 28.3 54.6 49.3 44.3 35.5 26.7 34.5 46.7 42.2 32.9

Registered nurse ................. 40.1 28.1 54.3 48.8 44.1 35.4 26.5 34.3 46.4 42.0 32.5

Resident/intern ................... 35.1 22.3 46.6 43.3 41.1 29.5 22.9 30.3 40.3 38.2 29.5

Other physician .................. 38.4 31.2 54.2 51.1 44.2 32.3 23.7 31.7 45.5 39.8 31.6

Licensed practical nurse ............. 39.0 27.9 49.8 45.0 42.6 33.7 27.8 32.5 46.2 41.4 31.0

Physician assistant ................ 47.1 33.9 53.5 50.5 51.6 44.3 36.1 38.3 56.0 49.0 40.4

Nurse practitioner ................. 46.0 27.3 54.0 52.0 50.1 44.3 33.7 37.7 54.8 48.9 56.0

. . . Category not applicable.

1Estimates for races other than white and black have been omitted because of small sample sizes.

Page 62 [ Series 13, No. 131
Table 44. Annual number and percent of emergency department visits by providers seen, according to hospital characteristics, averaged

over a 4-year period: United States, 1992–95

Provider seen Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits ................... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Staff physician ................... 31,114 6,814 8,888 9,255 6,157 24,677 6,437 21,273 3,149 6,692

Registered nurse ................. 31,066 6,645 9,453 9,054 5,913 24,688 6,378 21,450 3,340 6,276

Resident/intern ................... 4,221 1,006 1,725 1,061 429 3,988 234 2,683 1,118 420

Other physician .................. 3,905 575 964 1,750 616 2,627 1,278 2,780 376 748

Licensed practical nurse ............. 2,135 325 445 1,078 286 1,557 578 1,319 325 491

Physician assistant ................ 1,302 308 333 393 268 1,058 244 1,016 141 145

Nurse practitioner ................. 1,069 250 218 384 218 868 202 824 85 161

Percent of injury visits

All injury visits . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ... ...

Staff physician ................... 84.6 88.3 85.2 80.0 86.9 85.9 79.9 84.7 78.5 87.3

Registered nurse ................. 84.5 86.2 90.7 78.3 83.5 86.0 79.1 85.4 83.3 81.9

Resident/intern . . . . . . . . . . . . . . . . . . . 11.5 13.0 16.5 9.2 6.1 13.9 2.9 10.7 27.9 5.5

Other physician .................. 10.6 7.5 9.2 15.1 8.7 9.1 15.9 11.1 9.4 9.8

Licensed practical nurse . . . . . . . . . . . . . 5.8 4.2 4.3 9.3 4.0 5.4 7.2 5.3 8.1 6.4

Physician assistant . . . . . . . . . . . . . . . . 3.5 4.0 3.2 3.4 3.8 3.7 3.0 4.0 3.5 1.9

Nurse practitioner . . . . . . . . . . . . . . . . . 2.9 3.2 2.1 3.3 3.1 3.0 2.5 3.3 2.1 2.1

Percent of emergency department visits that are injury related

All injury visits ................... 39.8 40.8 40.8 37.6 40.8 39.9 39.5 40.8 34.4 39.8

Staff physician ................... 36.9 41.1 41.2 38.5 41.3 40.4 40.2 41.3 35.3 40.1

Registered nurse ................. 40.1 40.9 41.2 38.0 41.0 40.2 39.9 40.8 35.8 40.3

Resident/intern ................... 35.1 36.1 36.5 32.0 35.7 34.8 39.9 35.6 33.1 37.1

Other physician .................. 38.4 37.1 40.1 38.2 37.9 38.9 37.5 39.5 35.5 36.3

Licensed practical nurse ............. 39.0 47.3 43.2 35.0 41.7 39.8 37.0 42.0 28.7 40.8

Physician assistant ................ 47.1 47.5 47.5 51.1 41.7 48.4 42.3 48.5 37.5 49.8

Nurse practitioner ................. 46.0 46.8 47.6 48.1 40.6 46.2 44.9 46.1 38.9 50.3

. . . Category not applicable.

Series 13, No. 131 [ Page 63
Table 45. Annual number and percent of emergency department injury visits by expected source of payment, according to patient age, sex,

and race, averaged over a 4-year period: United States, 1992–95

Expected source of payment Total

Patient age Sex Race2

Under

5 years

5–14

years

15–24

years

25–44

years

45–64

years

65 years

and over Female Male White Black

Number of visits in thousands

All injury visits ................... 36,785 3,499 5,535 7,410 12,348 4,546 3,448 16,239 20,546 29,998 5,912

Private insurance ................. 12,725 1,101 2,400 2,659 4,356 2,003 206 5,311 7,414 11,177 1,306

Medicaid ...................... 5,935 1,276 1,370 950 1,503 448 289 3,165 2,770 4,109 1,656

Self-pay ....................... 5,716 409 626 1,611 2,419 573 78 2,142 3,574 4,356 1,189

Medicare ...................... 3,138 49 33 51 241 290 2,475 1,950 1,189 2,822 278

HMO1 ........................ 3,064 356 634 591 952 410 120 1,405 1,658 2,567 406

Other and unknown ................ 6,207 308 471 1,547 2,877 823 180 2,266 3,941 4,967 1,076

Percent distribution

All injury visits ................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Private insurance ................. 34.6 31.5 43.4 35.9 35.3 44.1 6.0 32.7 36.1 37.3 22.1

Medicaid ...................... 16.1 36.5 24.8 12.8 12.2 9.9 8.4 19.5 13.5 13.7 28.0

Self-pay ....................... 15.5 11.7 11.3 21.7 19.6 12.6 2.3 13.2 17.4 14.5 20.1

Medicare . . . . . . . . . . . . . . . . . . . . . . 8.5 1.4 0.6 0.7 1.9 6.4 71.8 12.0 5.8 9.4 4.7

HMO1 . . . . . . . . . . . . . . . . . . . . . . . . 8.3 10.2 11.5 8.0 7.7 9.0 3.5 8.7 8.1 8.6 6.9

Other and unknown ................ 16.9 8.8 8.5 20.9 23.3 18.1 5.2 14.0 19.2 16.6 18.2

Percent of emergency department visits that are injury related

All injury visits ................... 39.8 27.8 53.5 49.0 43.8 35.0 26.3 33.8 46.3 41.7 32.3

Private insurance ................. 46.6 37.1 60.9 53.7 45.8 37.8 33.3 39.2 53.9 47.9 37.9

Medicaid ...................... 27.5 20.4 42.2 29.3 28.9 22.4 23.5 24.7 31.6 28.8 24.9

Self-pay ....................... 44.2 33.4 57.3 48.0 44.6 36.4 31.9 25.9 51.4 46.1 38.6

Medicare ...................... 26.1 31.1 40.5 41.7 31.3 25.1 25.4 28.4 22.9 26.8 20.7

HMO1 ........................ 41.9 34.9 59.4 52.5 38.7 33.6 28.9 36.9 47.4 44.1 33.1

Other and unknown ................ 54.7 32.0 51.4 62.5 59.8 47.3 41.4 44.3 63.3 58.7 42.0

1HMO is health maintenance organization.

2Estimates for races other than white and black have been omitted because of small sample sizes.

Page 64 [ Series 13, No. 131
Table 46. Annual number and percent of emergency department injury visits by expected source of payment, according to geographic

region, metropolitan status, and hospital ownership, averaged over a 4-year period: United States, 1992–95

Expected source of payment Total

Geographic region Metropolitan status Ownership

Northeast Midwest South West Metropolitan

NonmetropolitanVoluntary,

nonprofit

Non-Federal

government Proprietary

Number of visits in thousands

All injury visits ................... 36,785 7,713 10,427 11,565 7,081 28,723 8,062 25,109 4,011 7,666

Private insurance ................. 12,725 2,667 4,131 3,885 2,042 9,393 3,331 9,121 1,029 2,575

Medicaid ...................... 5,935 1,162 1,576 1,956 1,241 4,535 1,400 3,975 741 1,219

Self-pay ....................... 5,716 1,233 1,294 2,182 1,007 4,735 981 3,684 890 1,142

Medicare ...................... 3,138 693 952 998 495 2,307 832 2,179 278 682

HMO1 ........................ 3,064 609 853 553 1,049 2,786 278 2,089 187 788

Other and unknown ................ 6,207 1,349 1,622 1,990 1,246 4,968 1,239 4,062 886 1,260

Percent distribution

All injury visits ................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Private insurance ................. 34.6 34.6 39.6 33.6 28.8 32.7 41.3 36.3 25.6 33.6

Medicaid ...................... 16.1 15.1 15.1 16.9 17.5 15.8 17.4 15.8 18.5 15.9

Self-pay ....................... 15.5 16.0 12.4 18.9 14.2 16.5 12.2 14.7 22.2 14.9

Medicare . . . . . . . . . . . . . . . . . . . . . . 8.5 9.0 9.1 8.6 7.0 8.0 10.3 8.7 6.9 8.9

HMO1 . . . . . . . . . . . . . . . . . . . . . . . . 8.3 7.9 8.2 4.8 14.8 9.7 3.4 8.3 4.7 10.3

Other and unknown ................ 16.9 17.5 15.6 17.2 17.6 17.3 15.4 16.2 22.1 16.4

Percent of emergency department visits that are injury related

All injury visits ................... 39.8 40.8 40.8 37.6 40.8 39.9 39.5 40.8 34.4 39.8

Private insurance ................. 46.6 47.1 47.0 44.4 49.9 46.7 46.5 47.1 44.0 46.0

Medicaid ...................... 27.5 26.9 29.5 26.3 27.7 27.1 28.8 28.0 23.7 28.4

Self-pay ....................... 44.2 44.9 46.0 42.8 44.6 44.3 43.8 45.8 39.6 43.3

Medicare ...................... 26.1 26.5 26.4 25.1 27.2 26.7 24.5 26.4 23.4 26.3

HMO1 ........................ 41.9 44.0 41.7 40.2 41.8 41.4 48.2 42.9 45.6 38.7

Other and unknown ................ 54.7 62.0 55.3 49.0 57.4 54.1 57.2 58.9 37.7 60.2

1HMO is health maintenance organization.

Series 13, No. 131 [ Page 65
Appendix I

Source of Data and Sample

Design

The information presented in this

report is based on data collected in the

1992, 1993, 1994, and 1995 National

Hospital Ambulatory Medical Care

Survey (NHAMCS). The data were

weighted and averaged to produce

annual estimates. The target universe of

NHAMCS includes visits made in the

United States by patients to emergency

departments (ED’s) and outpatient

departments (OPD’s) of non-Federal,

short-stay, and general hospitals.

Telephone contacts are excluded.

A four-stage probability sample

design is used in NHAMCS: the design

involves samples of primary sampling

units (PSU’s), hospitals with ED’s

and/or OPD’s within PSU’s, ED’s within

hospitals and/or clinics within OPD’s,

and patient visits within ED’s and/or

clinics. The hospital response rate for

NHAMCS during this period averaged

94 percent. The Patient Record forms

were slightly different over the 4 years

of data collection with the form

changing in 1993 and 1995 from the

1992 version (Appendix III). Hospital

staff were asked to complete patient

records for a systematic random sample

of patient visits occurring during a

randomly assigned 4-week reporting

period. The number of Patient Record

forms completed for ED’s was 36,271 in

1992; 29,117 in 1993; 26,547 in 1994;

and 21,886 in 1995. Table I provides the

number of sample hospitals providing

data in the 4-year period by geographic

region and metropolitan status.

Characteristics of the hospital, such

as ownership and expected number of

ED visits, were obtained from the

hospital administrator during an

induction interview. The U.S. Bureau of

the Census, Housing Surveys Branch,

was responsible for the survey’s data

collection. Data processing operations

and medical coding were performed

under the supervision of the National

Center for Health Statistics (NCHS),

Health Care Surveys Section, Research

Triangle Park, North Carolina. Actual

coding was performed by Analytical

Sciences Inc.

Sampling Errors

The standard error is primarily a

measure of the sampling variability that

occurs by chance when only a sample,

rather than an entire universe, is

surveyed. The standard error also

reflects part of the measurement error,

but does not measure any systematic

biases in the data. The chances are 95

out of 100 that an estimate from the

sample differs from the value that would

be obtained from a complete census by

less than twice the standard error.

The standard errors that were used

in tests of significance for this report

were calculated using SUDAAN, which

computes standard errors by using a

first-order Taylor approximation of the

deviation of estimates from their

expected values. A description of the

software and the approach it uses has

been published (6). The relative

standard error (RSE) of an estimate is

obtained by dividing the standard error

by the estimate itself. The result is then

expressed as a percent of the estimate.

Readers may approximate the

standard errors for estimates in this

report by using coefficients from

generalized linear models for predicting

the relative standard error for estimates

based on the linear relationship between

the actual standard error, as

approximated using SUDAAN software,

and the size of the estimate. Relative

standard errors for aggregate estimates

may be calculated using the following

general formula, where x is the

aggregate of interest in thousands and A

and B are the appropriate coefficients

from table II.

RSE (x) = ŒA +

B

x c 100

Similarly, relative standard errors

for an estimate of a percent may be

calculated using the following general

formula, where p is the percent of

interest, expressed as a proportion, and x

is the denominator of the percent in

thousands, using the appropriate

coefficients from table V.

RSE (x) = Œ B c (1 – p)

p c x c 100

Published and Flagged

Estimates

Estimates are not presented unless a

reasonable assumption regarding their

probability distributions is possible on

the basis of the Central Limit Theorem.

The Central Limit Theorem states that,

given sufficiently large sample sizes, the

sample estimate approximates the

population estimate and, upon repeated

sampling, its distribution would be

approximately normal. In this report,

estimates are not presented if they are

based on fewer than 30 cases in the

sample data; only an asterisk (*) appears

in the tables and figures.

Adjustments for Nonresponse

Estimates from NHAMCS data

were adjusted to account for sample

hospitals that were in scope but did not

participate in the study. This adjustment

was calculated to minimize the impact

of response on final estimates by

imputing to nonresponding hospitals

data from visits to similar hospitals. For

this purpose, hospitals were judged

similar if they were in the same region,

ownership control group, and

Table I. Number of participating hospitals with emergency department injury visits:

National Hospital Ambulatory Medical Care Survey 1992–95

Geographic region Total

Metropolitan status Ownership

Metropolitan

NonmetropolitanVoluntary

nonprofit

Non-Federal

government Proprietary

Northeast . . . . . . . . . . 119 108 11 89 11 19

Midwest . . . . . . . . . . . 128 104 24 106 9 13

South . . . . . . . . . . . . 166 130 36 91 21 54

West . . . . . . . . . . . . . 102 91 11 57 18 27

All hospitals . . . . . . . . 515 433 82 343 59 113

Page 66 [ Series 13, No. 131
metropolitan statistical area control

group.

Estimates from NHAMCS data

were also adjusted to account for ED’s

and sample clinics that were in scope

but did not participate in the study. This

adjustment was calculated to minimize

the impact of response on final estimates

by imputing to nonresponding ED’s or

clinics data from visits to similar ED’s

or clinics. For this purpose, ED’s or

clinics were judged similar if they were

in the same ED or clinic group.

Tests of Significance and

Rounding

The determination of statistical

inference is based on the t-test. The

Bonferroni inequality was used to

establish the critical value for

statistically significant differences (0.05

level of significance over all analyses

performed on estimates contained in a

table or figure). Terms relating to

differences such as ‘‘higher than’’

indicate that the difference is statistically

significant. A lack of comment regarding

the difference between any two

estimates does not mean that the

difference was tested and found to be

not significant.

In the tables, estimates of ED visits

have been rounded to the nearest

thousand. Consequently, estimates will

not always add to totals. Rates and

percents were calculated from original

unrounded figures and do not

necessarily agree with percents

calculated from rounded data.

Diagnosis and Injury

Groupings

Physicians’ diagnoses as shown in

tables 14–21 are grouped according to a

classification system developed for

analyzing injury data from the

NHAMCS. This grouping is based on

the International Classification of

Diseases, 9th Revision, Clinical

Modification (8), but also reflects the

frequency of diagnosis data in ED injury

visits. Table III shows the groupings

used to categorize the data.

External cause of injury is described

in terms of the mechanism that caused

the injury and the manner or intent.

This approach, developed through

collaborative work among NCHS, the

National Center for Injury Prevention

and Control (NCIPC), and the leadership

of the Injury Control and Emergency

Health Services (ICEHS) section of the

American Public Health Association

(APHA), emphasizes the mechanism

that caused the injury over the manner

or intent. The matrix framework shown

in table IV was used to describe cause

of injury for the tables and figures in

this report and is based on the

International Classification of Diseases,

9th Revision, Clinical Modification,

Supplementary Classification on

External Cause of Injury and Poisoning

(8). Definitions of categories used for

the mechanism that caused the injury

are found in Appendix II.

Population Figures and Rate

Calculation

The population figures used in

computing annual visit rates by age, sex,

Table II. Coefficients appropriate for determining approximate relative standard error by

type of estimate for hospital emergency department injury visits, averaged over a 4-year

period: National Hospital Ambulatory Medical Care Survey, 1992–95

Type of estimate

Coefficient for use with

estimates in thousands Lowest reliable

estimate

A B in thousands

Visits .................... 0.000917 1.29012 14

Drug mentions .............. 0.001476 3.25254 37

Table III. Reclassification of principal diagnosis codes

Principal diagnosis group1 ICD–9–CM code

Illness diagnoses ........................... 001–799

Musculoskeletal system ...................... 710–739

Symptoms and ill-defined conditions .............. 780–799

Skin and subcutaneous tissue .................. 680–709

Mental disorders .......................... 290–319

Nervous system and sense organs ............... 320–389

Other illnesses ........................... 001–289, 390–677, 740–779

Injury and poisoning ......................... 800–999

Fractures ............................... 813–819

Fracture of radius and ulna . . . . . . . . . . . . . . . . . . 813

Fracture of hand and fingers ................. 814–817

Fracture of lower limb ...................... 820–829

Other fractures .......................... 800–812, 818–819

Sprains and strains ......................... 842–848

Sprains and strains of wrist and hand . . . . . . . . . . . . 842

Sprains and strains of knee and leg . . . . . . . . . . . . . 844

Sprains and strains of ankle . . . . . . . . . . . . . . . . . . 845

Sprains and strains of neck . . . . . . . . . . . . . . . . . . 847

Other sprains and strains of back .............. 846, 847.1–847.9

Other sprains and strains ................... 840–841, 843, 845.1, 848

Open wounds ............................ 870–897

Open wound of head ...................... 870–873

Open wound of hand and fingers ............... 882–883

Other open wound ........................ 874–881, 884–897

Superficial injuries ......................... 910–924

Superficial injury of cornea ................... 918.1

Other superficial injury ..................... 910.0–918.0, 918.2, 919.9

Contusions with intact skin surfaces ............. 920–924

Other injuries ............................ 830–839, 850–854, 860–869, 900–909, 925–999

Intracranial injury, excluding those with skull fracture . . . 850–854

Other injuries ........................... 830–839, 860–869, 900–909, 925–959

Poisonings ............................ 960–989

Other and unspecified effects of external causes ..... 990–995

Complications of surgical and medical care, NEC2 .... 996–999

Supplementary classification of factors influencing health

status and contact with health services ............. V01–V82

Unknown and blank

1Based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9–CM) (8). 2NEC is not elsewhere classified.

Series 13, No. 131 [ Page 67
race, geographic region, and

metropolitan status for this report are

shown in tables V and VI. The figures

represent an average of the U.S. Bureau

of the Census estimates of the civilian

noninstitutionalized population as of

July 1 in each year between 1992–95.

They have been adjusted for net

underenumeration. Regional and

metropolitan status U.S. population

estimates were obtained from the

Division of Health Interview Statistics,

NCHS.

Appendix II

Definition of Terms

Patient—An individual seeking

personal health services who is not

Table IV. Proposed matrix for external cause of injury mortality and morbidity data

Mechanism or cause

Manner or intent

Unintentional

Suicide/

self-inflicted

Homicide/

assault Undetermined Other

Cut/pierce .................. E920.0–.9 E956 E966 E986 E974

Drowning/submersion ........... E830.0–.9, 832.0–.9, 910.0–.9 E954 E964 E984 . . .

Fall ...................... E880.0–886.9, 888 E957.0–.9 E968.1 E987.0–.9 . . .

Fire/hot object or substance ....... E890.0–899, 924.0–.9 E958.1,.2,.7 E961, 968.0, .3 E988.1,.2,.7 . . .

Fire/flame ................ E890.0–899 E958.1 E968.0 E988.1 . . .

Hot object/scald ............. E924.0–.9 E958.2,.7 E961, 968.3 E988.2,.7 . . .

Firearm ................... E922.0–.9 E955.0–.4 E965.0–.4 E985.0–.4 E970

Machinery .................. E919.0–.9 . . . . . . . . . . . .

Motor vehicle traffic ............ E810–819 (.0–.9) E958.5 E968.5 E988.5 . . .

Occupant................. E810–819 (.0,.1) . . . . . . . . . . . .

Motorcyclist ............... E810–819 (.2,.3) . . . . . . . . . . . .

Pedal cyclist ............... E810–819 (.6) . . . . . . . . . . . .

Pedestrian ................ E810–819 (.7) . . . . . . . . . . . .

Unspecified ............... E810–819 (.9) . . . . . . . . . . . .

Pedal cyclist, other ............ E800–807 (.3), E820–825 (.6),

E826 (1,.9), 827–829 (.1)

... ... ... ...

Pedestrian, other ............. E800–807 (.2), 820–825 (.7),

E826–829 (.0)

... ... ... ...

Transport, other .............. E800–807 (.0–.1,.8–.9),

E820–825 (.0–5,.8–9),

E826 (.2–8), 827–829, (.2–.9)

E831.0–9, 833.0–845.9

E958.6 . . . E988.6 . . .

Natural/environmental factors ...... E900.0–909, 928.0–.2 E958.3 . . . E988.3 . . .

Bites and stings ............. E905.0–.6,.9, 906.0–.4, .5, .9 . . . . . . . . .

Overexertion ................ E927 . . . . . . . . . . . .

Poisoning .................. E850.0–869.9 E950.0–952.9 E962.0–.9 E980.0–982.9 E972

Struck by, against ............. E916–917.9 . . . E960.0, 968.2 . . . E973, 975

Suffocation . . . . . . . . . . . . . . . . . E911–913.9 E953.0–.9 E963 E983.0–.9 . . .

Other specified and classifiable .... E846–848, 914–915, 918,

E921.0–.9, 923.0–.9,

E925.0–926.9, 929.0–.5

E955.5,.9, 958.0,.4 E960.1, 965.5–.9,

E967.0–.9, 968.4

E985.5, 988.0,.4 E971, 978

E990–994, 996,

E997.0–.2

Other specified, NEC1 .......... E928.8, 929.8 E958.8, 959 E968.8, 969 E988.8, 989 E995, 997.8, 977,

E998–999

Unspecified ................. E887, 928.9, 929.9 E958.9 E968.9 E988.9 E976, 997.9

All injury2 .................. E800–869, 880–929 E950–959 E960–969 E980–989 E970–978

E990–999

1Not elsewhere classifiable.

2Excludes fatal and nonfatal events caused by adverse events (E-codes E870–E879 and E930–E949).

NOTE: E-codes are based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9–CM) Supplementary Classification of External Cause of Injury and Poisoning

(8). E968.5 and E906.5 are the only codes that are singled out that are in ICD–9–CM but not in ICD-9. All of the other codes that are in CM only are folded into larger groupings in the matrix.

SOURCE: Injury Chartbook. Health, United States 1996–97 (1).

Page 68 [ Series 13, No. 131
currently admitted to any health care

institution on the premises.

Geographic region—The 50 States

and the District of Columbia are

grouped for statistical purposes by the

U.S. Bureau of the Census into four

geographic regions as follows:

+ Northeast—Maine, New Hampshire,

Vermont, Massachusetts, Rhode

Island, Connecticut, New York, New

Jersey, and Pennsylvania

+ Midwest—Ohio, Indiana, Illinois,

Michigan, Wisconsin, Minnesota,

Iowa, Missouri, North Dakota, South

Dakota, Nebraska, and Kansas

+ South—Delaware, Maryland,

District of Columbia, Virginia, West

Virginia, North Carolina, South

Carolina, Georgia, Florida,

Kentucky, Tennessee, Alabama,

Mississippi, Arkansas, Louisiana,

Oklahoma, and Texas

+ West—Montana, Idaho, Wyoming,

Colorado, New Mexico, Arizona,

Utah, Nevada, Washington, Oregon,

California, Alaska, and Hawaii

Hospital—All hospitals with an

average length of stay for all patients of

less than 30 days (short-stay) or hospital

whose specialty is general (medical or

surgical) or children’s general, except

Federal hospitals and hospital units of

institutions and hospitals with less than

six beds staffed for patient use.

Ownership—Hospitals are

designated according to the primary

owner based on the SMG Hospital

Market Database as follows:

+ Voluntary nonprofit—Hospitals

operated by a church or another

nonprofit organization.

+ Government, non-Federal—Hospitals

operated by State or local

governments.

+ Proprietary—Hospitals operated by

individuals, partnerships, or

corporations for profit.

Metropolitan status—Hospitals are

classified by their location in a

metropolitan or nonmetropolitan area as

follows:

+ Metropolitan Statistical Area

(MSA)—As defined by the U.S.

Office of Management and Budget,

the definition of an individual MSA

involves two considerations: first, a

city or cities of specified population

that constitute the central city and

identify the county in which it is

located as the central county;

second, economic and social

relationships with ‘‘contiguous’’

counties that are metropolitan in

character so that the periphery of the

specific metropolitan area may be

determined. MSA’s may cross State

lines. In New England, MSA’s

consist of cities and towns rather

than counties.

+ Non-MSA—Other than

metropolitan.

Emergency department—Hospital

facility for the provision of unscheduled

outpatient services to patients whose

conditions require immediate care and is

staffed 24 hours a day. If an ED

provided emergency services in different

areas of the hospital, then all these areas

were selected with certainty into the

sample. Off-site emergency departments

that are open less than 24 hours are

included if staffed by the hospital’s

emergency department.

Table V. U.S. population estimates used in computing annual visit rates by sex, age,

region, and metropolitan status, averaged over a 4-year period

Age, region, and

metropolitan status Total Female Male White Black Other

Number of persons in thousands

Total .................... 256,817 131,829 124,988 213,007 32,499 11,311

Age

Under 5 years .............. 20,079 9,805 10,273 15,807 3,287 . . .

5–14 years ................ 38,001 18,550 19,451 30,153 6,033 . . .

15–24 years ............... 35,261 17,639 17,621 28,078 5,277 . . .

25–44 years ............... 82,230 41,759 40,471 68,072 10,160 . . .

45–64 years ............... 50,100 25,958 24,142 43,039 5,144 . . .

65 years and over ............ 31,147 18,118 13,030 27,858 2,598 . . .

Geographic region

Northeast ................. 50,526 . . . . . . . . . . . . . . .

Midwest .................. 62,248 . . . . . . . . . . . . . . .

South ................... 87,563 . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . 56,480 . . . . . . . . . . . . . . .

Metropolitan status

Metropolitan ............... 202,201 . . . . . . . . . . . . . . .

Nonmetropolitan ............. 54,616 . . . . . . . . . . . . . . .

. . . Category not applicable.

SOURCE: Based on U.S. Bureau of the Census estimates of the civilian noninstitutionalized population of the United States, July

1, 1992–95. Figures have been adjusted for net underenumeration.

Table VI. U.S. population estimates used in computing annual visit rates by race, sex, and

age, averaged over a 4-year period

Age

White Black

Female Male Female Male

Number of persons in thousands

Total .................... 108,667 104,341 17,320 14,929

Under 5 years .............. 7,700 8,107 1,618 1,669

5–14 years ................ 14,699 15,454 2,971 3,062

15–24 years ............... 13,930 14,147 2,750 2,277

25–44 years ............... 34,107 33,966 5,566 4,594

45–64 years ............... 22,074 20,965 2,853 2,291

65 years and over ............ 16,157 11,702 1,562 1,036

SOURCE: Based on U.S. Bureau of the Census estimates of the civilian noninstitutionalized population of

the United States, July 1, 1992–95. Figures have been adjusted for net underenumeration.

Series 13, No. 131 [ Page 69
Visit—A visit is a direct, personal

exchange between a patient and a

physician or other health care provider

working under the physician’s

supervision for the purpose of seeking

care and receiving personal health

services. Telephone contacts are

out-of-scope for the NHAMCS.

Injury-related visit—A visit is

considered related to an injury if

hospital staff indicated by means of a

check box that the visit was a result of

any kind of accident or injury including

but not limited to, falls, lacerations,

burns, intentional injuries, unintentional

poisonings by drugs, medicinal

substances, biologicals, gases or vapors,

or adverse reaction to drugs;

complications of surgical and medical

procedures; and insect and animal bites.

Post data collection edits identified a

visit as an injury visit if any one of the

following conditions applied: an injury

check box was marked, a reason for

visit indicated an injury, a diagnosis

indicated an injury, or an external cause

of injury code was listed. For the

purposes of this report, records with an

external cause of injury coded as an

adverse effect of medical treatment

(ICD–9–CM codes E870–E879,

E930–E949) are excluded from the

injury definition.

Terms Relating to the

Patient Record Forms

Age—Age, calculated from date of

birth, is the age at last birthday on the

date of visit.

Race—Hospital staff were instructed

to record race based on observation or

the hospital’s usual practice or

knowledge. The following category

definitions were provided:

+ White—A person having origins in

any of the original peoples of

Europe, North Africa, or the Middle

East.

+ Black—A person having origins in

any of the black racial groups of

Africa.

+ Asian/Pacific Islander—A person

having origins in any of the original

peoples of the Far East, Southeast

Asia, the Indian Subcontinent, or the

Pacific Islands. This area includes,

for example, China, India, Japan,

Korea, the Philippine Islands, and

Samoa.

+ American Indian/Eskimo/Aleut—A

person having origins in any of the

original peoples of North America

and who maintains cultural

identification through tribal

affiliation or community recognition.

Ethnicity—Hospital staff were

instructed to mark the appropriate

category based on the hospital’s usual

practices.

+ Hispanic origin—A person of

Mexican, Puerto Rican, Cuban,

Central or South American, or other

Spanish culture or origin, regardless

of race.

+ Not Hispanic—All other persons.

Expected source(s) of payment—

Hospital staff were instructed to check

the source(s) that would pay for this

visit.

+ Medicare—Charges paid in part or

in full by a Medicare plan. Includes

payments made directly to the

hospital as well as payments

reimbursed to the patient.

+ Medicaid—Charges paid in part or

in full by a Medicaid plan. Includes

payments made directly to the

hospital as well as payments

reimbursed to the patient.

+ Other government—Charges paid in

part or in full by any other local,

State, or Federal health care

programs, such as worker’s

compensation programs and Civilian

Health and Medicaid Programs of

Uniformed Services (CHAMPUS).

+ Private/commercial—Charges paid

in part or in full by a private

insurance company. Includes

payments made directly to the

hospital as well as payments

reimbursed to the patient.

+ HMO/other prepaid—Charges

included under a prepayment plan.

Includes health maintenance

organizations (HMO’s), independent

practice associations (IPA’s),

preferred provider organizations

(PPO’s), etc.

+ Patient paid—Charges paid in part

or in full by the patient or the

patient’s family that will not be

reimbursed by a third party. Includes

‘‘co-payments’’ and ‘‘insurance

deductibles.’’ Excludes prepaid plan

visits for which no co-payment is

charged.

+ No charge—Visits for which no fee

is charged.

+ Other—Any other source of

payment not covered in the

categories above.

For purposes of this report, visits

with multiple responses were assigned

to one category as the primary expected

source of payment in the following

hierarchy: Medicaid, Medicare, HMO or

other prepaid insurance, private

insurance, self-pay, and other. The

categories are the same as defined

previously except the ‘‘other’’ category

includes visits with no charge to the

patient, visits paid by government

sources other than Medicare and

Medicaid, and visits paid by worker’s

compensation or other and unknown

sources.

Major reason for this visit

(1992)—Hospital staff were instructed to

indicate whether this visit is the first

visit or followup visit for an injury or

illness.

+ Injury, first visit—Self-explanatory.

+ Injury, followup—Self-explanatory.

+ Illness, first visit—Self-explanatory.

+ Other reason—Includes general

health maintenance examinations,

routine periodic examinations of

presumably healthy persons—both

children and adults—and

malingering.

Place of injury (1993–94)—Type of

location where the injury occurred.

+ Home—Includes noninstitutional

places of residence and surrounding

yard.

+ Work—Includes industrial or

agricultural places, mine and quarry

pits, offices, sport or school areas

where the patient works.

+ School/day care—Includes

classrooms and sport/recreational

areas of all school and day care

facilities, including universities.

+ Street/highway—Includes all public

streets, roads, and highways.

+ Other—Includes residential

institutions, recreational and sport

areas, public buildings, and natural

areas.

Page 70 [ Series 13, No. 131
Place of injury (1995)—Type of

location where the injury occurred.

+ Home—Includes noninstitutional

places of residence and surrounding

yard.

+ School—Includes classrooms and

recreational and sport areas of all

school and day care facilities,

including universities.

+ Sport or athletics area—Includes

sport fields, gymnasiums, public

swimming pools, resorts, parks, and

stadiums.

+ Street or highway—Includes all

public streets, roads, and highways.

+ Other—Includes residential

institutions, public buildings, and

natural areas.

+ Unknown—Place not specified.

Cause of injury—Hospital staff

were instructed to describe in detail the

events and circumstances surrounding

the injury; for example, the place and

cause of injury.

Patient’s complaint(s), symptom(s),

or other reason(s) for this visit (in

patient’s own words)—The patient’s

problem, complaint, symptom, or other

reason for this visit as expressed by the

patient. Hospital staff were instructed to

record key words or phrases verbatim to

the extent possible. ‘‘Most important’’

refers to that problem which, in their

judgment, is most responsible for the

patient’s visit.

Physician’s diagnosis—The

physician’s best assessment of diagnosis

of the patient’s most important problem,

complaint, or symptom. The term

‘‘principal’’ refers to the first listed

diagnosis. The diagnosis represents the

hospital staff’s best judgment at the time

of the visit and may be tentative,

provisional, or definitive.

Urgency of this visit—Hospital staff

were instructed to check the category

that best indicated the urgency of the

visit.

+ Urgent/emergent—Patient requires

immediate attention for acute illness

or injury that threatens life or

function. Delay would be harmful to

the patient.

+ Nonurgent—Patient does not require

attention immediately or within a

few hours.

Alcohol and/or drug related—

Patient’s most important complaint or

presenting problem is alcohol and/or

drug related.

Diagnostic/screening services—

Hospital staff were instructed to mark

all services and procedures that were

ordered or provided during this visit for

the purpose of screening or diagnosis.

+ Blood pressure check—Selfexplanatory.

+ Urinalysis—Any physical, chemical,

or microscopic examination or urine.

+ HIV serology—The study of the

human immunodeficiency virus

(HIV) antigen-antibody reaction in

vitro.

+ Cholesterol measure—A blood test

taken to measure the level of

cholesterol in a patient’s blood.

+ Other blood test—Self-explanatory.

+ Mental status exam—Any formal,

clinical evaluation designed to

assess the mental or top emotional

status of the patient.

+ Chest x ray—Single or multiple x

rays of the chest for diagnostic or

screening purposes. Excludes

fluoroscopy and studies of ribs, bony

thorax, and spine.

+ Extremity x ray—X ray of the arms,

legs, hands, or feet.

+ CT scan/MRI—Computerized

tomography scan/magnetic

resonance imaging.

+ Other diagnostic imaging—

Self-explanatory.

Procedures—Hospital staff were

instructed to mark all procedures

provided this visit.

+ Endotracheal intubation—A

laryngoscope inserted into the mouth

followed by a tube into the trachea.

+ CPR—Cardiopulmonary

resuscitation.

+ IV fluids—Administration of

intravenous fluids.

+ NG tube—Administration of

intravenous fluids.

+ Gastric lavage—Passage of a

solution through the inflow tube into

the nose, down the esophagus, and

into the stomach where the gastric

contents are irrigated and returned

through an outflow tube.

+ Wound care—Includes cleaning,

debridement, and dressing of burns;

repair of lacerations with skin tape

or sutures; removal of foreign

bodies; excisions, and incision and

drainage.

+ Eye/ENT care—Care provided to the

eyes, ears, nose, and throat; includes

measurement of intraocular pressure

in the eyes, removal of ear wax,

removal of foreign bodies, nasal

packing, and laryngoscopy.

+ Orthopedic care—Treatment of

orthopedic injuries or conditions;

includes casting, wrapping, splinting,

and aspiration of fluid from joints.

+ Bladder catheter—Any type of

catheter used to catheterize the

bladder, for example, Foley.

+ Lumbar puncture—Insertion of a

needle into the lumbar spine to

extract spinal fluid for laboratory

examination.

+ Other(s) specify—Up to two other

diagnostic and/or treatment

procedures provided this visit were

recorded.

Medication—Hospital staff were

instructed to list, using brand or generic

names, all medications ordered, injected,

administered, or provided this visit

including prescription and

nonprescription drugs, immunizations,

and desensitizing agents. Also included

are drugs and medications ordered or

provided prior to the visit that the

patient was instructed to continue

taking.

Disposition—Hospital staff were

instructed to mark all categories that

apply.

+ Return to ED PRN—The patient is

instructed to return to the ED as

needed.

+ Return to ED-appointment—The

patient is told to schedule an

appointment or is given an

appointment to return to the ED at a

particular time.

+ Return to referring physician—The

patient was referred to the ED by

his or her personal physician orsome

other physician and is now

instructed to consult again with the

physician who made the referral.

Series 13, No. 131 [ Page 71
+ Refer to other physician/clinic—The

patient is instructed to consult or

seek care from another physician or

clinic. The patient may or may not

return to this physician or clinic at a

later date.

+ Admit to hospital—The patient is

instructed that further care or

treatment will be provided as an

inpatient in the hospital.

+ Admit to ICU/CCU (1995)—The

patient is admitted to the Intensive

Care Unit or to the Critical Care

Unit of the hospital.

+ Transfer to other facility—The

patient is transferred to facility other

than a facility operated under the

auspices of this hospital.

+ DOA/died in the ED—If the patient

is dead on arrival (DOA) or died in

the ED, this patient is still included

in the sample.

+ Left AMA—If the patient was

registered to be seen but left prior to

being seen by a health care provider

or left against medical advice

(AMA), this patient is still included

in the sample.

+ No followup planned—No return

visit or telephone contact is

scheduled or planned for the

patient’s problem on this visit.

+ Left before being seen (1995)—The

patient left the hospital before

receiving any medical care.

+ Other—Any other disposition of the

case not included in the categories

previously mentioned.

Providers—Hospital staff were

instructed to mark all providers seen by

the patient during this visit.

+ Resident/intern—Persons graduated

from medical school and in training.

+ Staff physician—Physician who is

employed by the hospital or the

university affiliated with the hospital

and is a member of the hospital

staff.

+ Other physician—Consulting

physicians and other part-time

physicians who are not considered

to be members of the hospital staff.

+ Physician assistant—Certified health

care professional who delivers

health care services under the

supervision of a licensed physician.

+ Nurse practitioner—Registered

nurse with advanced training who

provides primary health care

services. Supervision by a physician

is required in some States.

+ Registered nurse—Self-explanatory.

+ Licensed practical nurse—

Self-explanatory.

+ Nurse’s aide—Self-explanatory.

External Cause of Injury

Category Descriptions for

Mechanism Regardless of

Intent

Falls: E–codes: E880–E886,

E888, E957, E968.1, E987

Includes falls from higher levels,

stairs, slips, trips, pushing from high

places, and falling from a high place

with no mention of intent.

Struck by/against: E–codes:

E916–E917, E960.0, E968.2,

E973, E975

Includes injuries caused by being

struck by or striking against a person or

object. This includes unintentional

strikes, injuries sustained in sporting

activities and unarmed assault situations,

and injuries caused by being struck by

flying objects or objects being thrown.

Motor vehicle traffic: E–codes:

E810–E819, E958.5, E988.5

Includes motor vehicle

traffic-related injuries involving

automobiles, vans, trucks, motorcycles,

and other motorized cycles traveling on

public roads and highways regardless of

the patient’s involvement in the incident

(for example, occupant, motorcyclist,

pedal cyclist, or pedestrian). It does not

include nontraffic-related injuries

involving motor vehicles but it does

include suicide attempts using motor

vehicles or injuries caused by

undetermined intent.

Cut/pierce: E–codes: E920,

E956, E966, E974, E986

Includes injuries caused by cutting

and piercing instruments including

knives, daggers, power lawn mowers,

power hand tools, household appliances,

or other and unspecified sharp objects

regardless of intent.

Overexertion: E–code: E927

Includes injuries caused by

excessive physical exercise; overexertion

from lifting, pulling, or pushing; and

strenuous movements in recreational and

other activities.

Natural/environmental:

E–codes: E900–E909, E928.0–.2,

E958.3, E988.3

Includes injuries caused from a

variety of natural and environmental

factors including but not limited to

excessive exposure to extreme

temperature and weather conditions (for

example, excessive heat or cold,

cataclysmic storms or surface

movements, lightning strikes, and

floods), bites, stings, and reactions from

insects, animals, and plants (for

example, snakes, wasps, bees, dogs, rats,

and poison ivy), and conditions of

neglect (for example, hunger, thirst, and

exposure).

Poisoning: E–codes:

E850–E869, E950–E952, E962,

E972, E980–E982

Includes unintentional and

intentional poisoning by drugs,

medicinal substances, biologicals, and

other solid and liquid substances, gases,

and vapors (for example, alcohol,

corrosives and caustics, insecticides,

barbiturates, and carbon monoxide). It

excludes adverse effects of drugs or

medicinals used in therapeutic use.

Fire/burn: E–codes:

E890–E899, E924, E958.1,.2,.7,

E961, E968.0,.3, E988.1,.2,.7

Includes injuries from fires, flames,

smoke and hot objects, and substances.

Page 72 [ Series 13, No. 131
It does not include burns from electrical

current, explosions, or exposure to

radiation.

Other pedal cycle: E–codes:

E800–E807 (.3), E820–E825 (.6),

E826.1,.9

Includes all injuries among pedal

cyclists not involving motor vehicle

traffic incidents such as falls from

cycles, collision between the pedal cycle

and other pedal cycles, pedestrians, and

animals. Injuries to people other than

the cyclist (E926.0,.2–.8), are not

included here but are grouped in the

‘‘Other mechanism’’ category.

Machinery: E–code: E919

Includes injuries associated with

machinery used in various industrial and

occupational activities whether the

specific mechanism be cuts, falls, struck

by, or pinned under. It includes

agricultural, lifting, metalworking,

woodworking, and earth-moving

machines, motor, and transmission

devices.

Firearm: E–codes: E922,

E955.0–.4, E965.0–.4, E970,

E985.0–.4

Includes all codes related to gunshot

injuries regardless of intent. These

would include wounds from handguns,

shotguns, hunting rifles, and police and

military firearms. It does not include

injuries other than gunshot wounds that

may be caused by guns such as pistol

whippings or injuries from explosives,

nor does it include nonpowder-charge

weapons like BB and pellet guns.

Other transportation: E–codes:

E800–E807 (.0,.1,.8,.9),

E820–E825 (.0–.5,.8,.9),

E826.2–.8, E827–E829(.2–.9),

E831, E833–E845

Includes injuries associated with

transportation other than motor vehicle

traffic incidents, pedal cyclists, and

pedestrians. It includes off-road and

other motor vehicles not in traffic, and

injuries caused by water, railway, and

air transport.

Suffocation: E–codes:

E911–E913, E953, E963, E983

Includes injuries caused from lack

of air to the lungs by either the

inhalation of food or other objects that

block respiration or by other mechanical

means of hindering breathing (for

example, plastic bags over mouth and

nose, attempted hanging, or

strangulation).

Other mechanism: E–codes: see

table IV

In addition to the codes listed under

‘‘Other mechanism’’ in table IV, this

category also includes codes found

under ‘‘Pedestrian, other’’ and

‘‘Drowning.’’ The frequency of

ambulatory care visits for these two

categories was not large enough to

warrant separate categories as it

would for mortality statistics. This

catch-all category includes late effects of

specified injuries, electrical and

explosive burns, foreign body entering

an orifice, caught accidentally in or

between objects, rape, and child

battering.

Not elsewhere classifiable

(NEC): E–codes: E928.8,

E929.8, E958.8, E959, E968.8,

E969, E988.8, E989, E995,

E997.8, E977, E998–E999

Includes injury visits where the

mechanism was specified but no specific

E–code exists to cover it such as

responses coded to ‘‘assault by other

specified means’’ (E968.8).

Mechanism not specified:

E–codes: E887, E928.9, E929.9,

E958.9, E968.9, E988.9, E976,

E997.9

Includes all injury visits where a

nonspecific cause was reported such as

‘‘unspecified accident’’ (E928.9), ‘‘late

effects of unspecified accident’’

(E929.9), and ‘‘assault by unspecified

means’’ (E968.9).

Blank cause of injury

Includes all injury visits where

nothing was recorded in the cause of

injury item.

Series 13, No. 131 [ Page 73
Appendix III

Survey Instruments

Page 74 [ Series 13, No. 131
Series 13, No. 131 [ Page 75

Vital and Health Statistics

series descriptions

SERIES 1. Programs and Collection Procedures—These reports describe

the data collection programs of the National Center for Health

Statistics. They include descriptions of the methods used to

collect and process the data, definitions, and other material

necessary for understanding the data.

SERIES 2. Data Evaluation and Methods Research—These reports are

studies of new statistical methods and include analytical

techniques, objective evaluations of reliability of collected data,

and contributions to statistical theory. These studies also include

experimental tests of new survey methods and comparisons of

U.S. methodology with those of other countries.

SERIES 3. Analytical and Epidemiological Studies—These reports present

analytical or interpretive studies based on vital and health

statistics. These reports carry the analyses further than the

expository types of reports in the other series.

SERIES 4. Documents and Committee Reports—These are final reports of

major committees concerned with vital and health statistics and

documents such as recommended model vital registration laws

and revised birth and death certificates.

SERIES 5. International Vital and Health Statistics Reports—These

reports are analytical or descriptive reports that compare U.S.

vital and health statistics with those of other countries or present

other international data of relevance to the health statistics

system of the United States.

SERIES 6. Cognition and Survey Measurement—These reports are from

the National Laboratory for Collaborative Research in Cognition

and Survey Measurement. They use methods of cognitive science

to design, evaluate, and test survey instruments.

SERIES 10. Data From the National Health Interview Survey—These

reports contain statistics on illness; unintentional injuries;

disability; use of hospital, medical, and other health services; and

a wide range of special current health topics covering many

aspects of health behaviors, health status, and health care

utilization. They are based on data collected in a continuing

national household interview survey.

SERIES 11. Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and the

Hispanic Health and Nutrition Examination Survey—Data

from direct examination, testing, and measurement on

representative samples of the civilian noninstitutionalized

population provide the basis for (1) medically defined total

prevalence of specific diseases or conditions in the United States

and the distributions of the population with respect to physical,

physiological, and psychological characteristics, and (2) analyses

of trends and relationships among various measurements and

between survey periods.

SERIES 12. Data From the Institutionalized Population Surveys—

Discontinued in 1975. Reports from these surveys are included in

Series 13.

SERIES 13. Data From the National Health Care Survey—These reports

contain statistics on health resources and the public’s use of

health care resources including ambulatory, hospital, and

long-term care services based on data collected directly from

health care providers and provider records.

SERIES 14. Data on Health Resources: Manpower and Facilities—

Discontinued in 1990. Reports on the numbers, geographic

distribution, and characteristics of health resources are now

included in Series 13.

SERIES 15. Data From Special Surveys—These reports contain statistics on

health and health-related topics collected in special surveys that

are not part of the continuing data systems of the National

Center for Health Statistics.

SERIES 16. Compilations of Advance Data From Vital and Health

Statistics—Advance Data Reports provide early release of

information from the National Center for Health Statistics’ health

and demographic surveys. They are compiled in the order in

which they are published. Some of these releases may be

followed by detailed reports in Series 10–13.

SERIES 20. Data on Mortality—These reports contain statistics on mortality

that are not included in regular, annual, or monthly reports.

Special analyses by cause of death, age, other demographic

variables, and geographic and trend analyses are included.

SERIES 21. Data on Natality, Marriage, and Divorce—These reports

contain statistics on natality, marriage, and divorce that are not

included in regular, annual, or monthly reports. Special analyses

by health and demographic variables and geographic and trend

analyses are included.

SERIES 22. Data From the National Mortality and Natality

Surveys—Discontinued in 1975. Reports from these sample

surveys, based on vital records, are now published in Series 20

or 21.

SERIES 23. Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception, infertility, cohabitation, marriage,

divorce, and remarriage; adoption; use of medical care for family

planning and infertility; and related maternal and infant health

topics. These statistics are based on national surveys of women

of childbearing age.

SERIES 24. Compilations of Data on Natality, Mortality, Marriage,

Divorce, and Induced Terminations of Pregnancy—These

include advance reports of births, deaths, marriages, and divorces

based on final data from the National Vital Statistics System that

were published as supplements to the Monthly Vital Statistics

Report (MVSR). These reports provide highlights and summaries

of detailed data subsequently published in Vital Statistics of the

United States. Other supplements to the MVSR published here

provide selected findings based on final data from the National

Vital Statistics System and may be followed by detailed reports

in Series 20 or 21.

For answers to questions about this report or for a list of reports published in

these series, contact:

Data Dissemination Branch

National Center for Health Statistics

Centers for Disease Control and Prevention

6525 Belcrest Road, Room 1064

Hyattsville, MD 20782-2003

(301) 436–8500

E-mail: nchsquery@cdc.gov

Internet: www.cdc.gov/nchswww
DHHS Publication No. (PHS) 98-1792, Series 13, No. 131

7-0839 (1/98)

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