NCHS Data Brief ■ No. 185 ■ January 2015

u.s. department of health and human services

centers for disease control and prevention

national center for health statistics

Emergency Department Visits for Motor Vehicle Traffic 

Injuries: United States, 2010–2011

Michael Albert, M.D., M.P.H.; and Linda F. McCaig, M.P.H.

Key findings 

Data from the National 

Hospital Ambulatory 

Medical Care Survey, 

2010–2011

● In 2010–2011, the 

emergency department (ED) 

visit rate for motor vehicle 

traffic injuries was highest 

among persons aged 16–24 

years. The rates declined with 

age after 16–24, with rates 

for those aged 0–15 similar to 

those 65 and over.

● The overall ED visit rate 

for motor vehicle traffic 

injuries was higher among 

non-Hispanic black persons 

compared with non-Hispanic 

white and Hispanic persons.

● Imaging services were 

ordered or provided at 70.2% 

of ED visits for motor vehicle 

traffic injuries, which was 

higher than for other injuryrelated ED visits (55.9%).

● About one-half of ED visits 

for motor vehicle traffic injuries 

had a primary diagnosis of 

sprains and strains of the neck 

and back, contusion with 

intact skin surface, or spinal 

disorders.

In spite of improvements in motor vehicle safety in recent years, motor vehicle 

crashes remain a major source of morbidity and mortality in the United States 

(1–3). Motor vehicle-related deaths and injuries also result in substantial 

economic and societal costs related to medical care and lost productivity (4). 

This report describes the rates and characteristics of emergency department 

(ED) visits for motor vehicle traffic injuries during 2010–2011 based on 

nationally representative data from the National Hospital Ambulatory Medical 

Care Survey (NHAMCS). 

Keywords: health care utilization • injury • National Hospital Ambulatory 

Medical Care Survey

Did ED visit rates for motor vehicle traffic injuries differ by 

age? 

● In 2010–2011, there were an estimated 3.9 million annual average ED 

visits for motor vehicle traffic injuries. The overall ED visit rate for 

motor vehicle traffic injuries was 129 per 10,000 persons (Figure 1). 

Figure 1. Emergency department visit rates for motor vehicle traffic injuries, by age:

United States, 2010–2011 Visits per 10,000 persons

1

Visit rates are significantly different (p < 0.05) for all age group comparisons except for 0–15 compared with 65 and over based 

on a two-tailed t test.

NOTES: Figures are based on 2-year averages. Based on a sample of 1,942 emergency department visits for motor vehicle 

traffic injuries made during 2010–2011, representing an annual average weighted total of 3.9 million visits. Visit rates are based 

on the July 1, 2010, and July 1, 2011, set of estimates of the civilian noninstitutionalized population of the United States, as 

developed by the Population Division, U.S. Census Bureau.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2010–2011.

129

1

70

286

167

95

65

0

50

100

150

200

250

300

All 0–15 16–24

Patient age (years)

25–44 45–64 65 and over
NCHS Data Brief ■ No. 185 ■ January 2015

■  2  ■

● The ED visit rate for motor vehicle traffic injuries was highest among persons aged 16–24 

years. The rate increased from 70 per 10,000 persons among those aged 0–15 to peak at 

286 per 10,000 persons for those aged 16–24. The rate then declined with increasing age, 

reaching a rate of 65 per 10,000 persons for those aged 65 and over.

Did ED visit rates for motor vehicle traffic injuries differ by race and 

ethnicity? 

● The overall ED visit rate for motor vehicle traffic injuries was higher among non-Hispanic 

black persons (260 per 10,000 persons) compared with non-Hispanic white persons (119 per 

10,000 persons) and Hispanic persons (104 per 10,000 persons) (Figure 2).

● The visit rate was higher for non-Hispanic black persons compared with Hispanic persons 

for all age groups. The visit rate was higher for non-Hispanic black persons compared with 

non-Hispanic white persons for all age groups except 16–24.

● For persons aged 16–24, the visit rate was higher for non-Hispanic white persons compared 

with Hispanic persons.

Figure 2. Emergency department visit rates for motor vehicle traffic injuries, by age and race and ethnicity:

United States, 2010–2011

1

Visit rate for non-Hispanic black persons is significantly different (p < 0.05) from non-Hispanic white persons and Hispanic persons based on a two-tailed t

test. 2

Visit rate for Hispanic persons is significantly different (p < 0.05) from non-Hispanic white persons and non-Hispanic black persons for the age group 16–24 

based on a two-tailed t test.

NOTES: Figures are based on 2-year averages. Visit rates are based on the July 1, 2010, and July 1, 2011, set of estimates of the civilian noninstitutionalized

population of the United States, as developed by the Population Division, U.S. Census Bureau.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2010–2011. Visits per 10,000 persons

Patient age (years)

Non-Hispanic white Non-Hispanic black Hispanic

119

54

317

155

75

1

260

1

161

419

1

360

1

182

104

64

2

169

130

78

0

100

200

300

400

500

All 0–15 16–24 25–44 45 and over
NCHS Data Brief ■ No. 185 ■ January 2015

■  3  ■

Did arrival by ambulance, triage status, and hospital admission differ for 

motor vehicle traffic injury ED visits compared with other injury-related ED 

visits? 

● Ambulance was the mode of arrival for 42.9% of ED visits for motor vehicle traffic injuries. 

This percentage was more than twice as high as for other injury-related ED visits (16.6%) 

(Figure 3). 

● In spite of more frequent arrival by ambulance, the percentage of ED visits for motor 

vehicle traffic injuries with a triage status of immediate or emergent (11.4%) was only 

slightly higher than for other injury-related ED visits (8.9%).

● No statistically significant difference was observed in the percentage of ED visits for motor 

vehicle traffic injuries leading to hospital admission (5.7%) compared with other injuryrelated ED visits (6.6%).

Figure 3. Percentage of injury-related emergency department visits, by ambulance arrival, triage status, and hospital

admission, according to cause of injury: United States, 2010–2011

1

Percentage is significantly different (p < 0.05) for motor vehicle traffic injuries compared with other causes of injury based on a two-tailed t test.

NOTE: Figures are based on 2-year averages. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2010–2011. Percent of visits

1

42.9

1

11.4

5.7

16.6

8.9

6.6

0

10

20

30

40

50

Ambulance Triage status of immediate

or emergent

Admitted to the hospital

Motor vehicle traffic injuries Other causes of injury
NCHS Data Brief ■ No. 185 ■ January 2015

■  4  ■

Did the percentage of imaging tests ordered or provided at ED visits for 

motor vehicle traffic injuries differ from other injury-related ED visits? 

● Imaging was ordered or provided at 70.2% of ED visits for motor vehicle traffic injuries, 

which was higher than for other injury-related ED visits (55.9%) (Figure 4).

● A higher percentage of x-rays, any computerized tomography (CT) scans, head CT scans, 

CT scans other than head, and other imaging were ordered or provided at ED visits for 

motor vehicle traffic injuries compared with other injury-related ED visits.

Figure 4. Percentage of injury-related emergency department visits with imaging tests ordered or provided, according to

cause of injury: United States, 2010–2011 Percent of visits

Imaging tests

Motor vehicle traffic injuries Other causes of injury

NOTES: Figures are based on 2-year averages. Comparisons of motor vehicle traffic injuries with other causes of injury are significantly different (p < 0.05) 

for all imaging test categories based on a two-tailed t test. More than one imaging test may be reported per visit. CT is computerized tomography. “Any CT

scan” may include visits with CT scan of head, CT scan other than head, or both. “Other imaging” includes visits with the following tests: magnetic resonance

imaging or MRI, ultrasound, or other imaging.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2010–2011.

70.2

58.5

29.6

20.3 19.0

3.6

55.9

46.9

15.4

11.5

6.5

2.1

0

20

40

60

80

Any imaging X-ray Any CT scan CT scan

of head

CT scan other

than head

Other imaging
NCHS Data Brief ■ No. 185 ■ January 2015

■  5  ■

What were the leading primary diagnoses associated with ED visits for 

motor vehicle traffic injuries? Did these differ from other injury-related ED 

visits? 

● Sprains and strains of the neck and back (23.6%) was the leading primary diagnosis 

associated with ED visits for motor vehicle traffic injuries, followed by contusion with 

intact skin surface (15.2%) and then spinal disorders (8.0%) (Figure 5). These diagnoses, 

along with observation and evaluation for suspected conditions not found (5.4%), were more 

likely to be made at ED visits for motor vehicle traffic injuries compared with other injuryrelated ED visits. 

● Sprains and strains excluding neck and back (6.5%), fractures (6.1%), and open wounds 

(3.7%) were also among the leading primary diagnoses, but were less likely to be made at 

ED visits for motor vehicle traffic injuries compared with other injury-related ED visits.

Figure 5. Percentage of injury-related emergency department visits, by leading primary diagnoses, according to cause 

of injury: United States, 2010–2011

Sprains or

strains of

neck and

back

Contusion with

intact skin

surface

Spinal

disorders

Sprains or

strains

excluding

neck and

back

Fractures Observation

and evaluation

for suspected

conditions not

found

Open wound

Percent of visits

Motor vehicle traffic injuries Other causes of injury

NOTES: Figures are based on 2-year averages. Categories based on the International Classification of Diseases, Ninth Revision, Clinical Modification

(ICD–9–CM). All percentages are significantly different (p < 0.05) for motor vehicle traffic injuries compared with other causes of injury based on a two-tailed

t test.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2010–2011.

23.6

15.2

8.0

6.5 6.1 5.4

3.8 3.7

11.7

3.0

10.0 10.7

0.6

16.9

0

10

20

30

Diagnosis
NCHS Data Brief ■ No. 185 ■ January 2015

■  6  ■

Summary

This analysis of NHAMCS data indicates that in 2010–2011, there were approximately 3.9 

million ED visits for motor vehicle traffic injuries annually, which accounted for 10.1% of all 

injury-related ED visits. Visit rates were highest among those aged 16–24 and then declined with 

age, with rates for persons aged 0–15 similar to those for persons aged 65 and over. Visit rates 

were also higher for non-Hispanic black persons compared with non-Hispanic white and Hispanic 

persons. Although arrival by ambulance occurred more than twice as often for ED visits for motor 

vehicle traffic injuries than for other injury-related ED visits, the percentage with a triage status 

of immediate or emergent was only slightly higher, and there was no difference in the percentage 

admitted to the hospital. Imaging was more frequently ordered or provided at ED visits for motor 

vehicle traffic injuries compared with other injury-related ED visits. Finally, sprains and strains 

of the neck and back, contusion with intact skin surface, and spinal disorders accounted for about 

one-half of all ED visits for motor vehicle traffic injuries. 

Injury prevention objectives were recently outlined for Healthy People 2020, and these include 

reducing motor vehicle crash-related deaths and nonfatal motor vehicle crash-related injuries 

(5). Data on the rates and characteristics of ED visits for motor vehicle traffic injuries can help 

inform public health efforts aimed at meeting these objectives and continuing the progress made 

in improving motor vehicle safety.

Definitions

Injury-related visit: A visit in which a first-, second-, or third-listed external cause of injury, or 

first-, second-, or third-listed reason for visit or diagnosis code that is injury- or poison-related 

was recorded. Adverse effect and medical and surgical misadventure or complication external 

cause-of-injury codes were excluded; however, if these codes were present in combination with 

other valid definitional codes, the visit was considered injury-related. Diagnosis and external 

cause of injury were coded using the International Classification of Diseases, Ninth Revision,

Clinical Modification (ICD–9–CM) (6).

Visit for motor vehicle traffic injury: An injury-related visit with a first-listed external cause-ofinjury code of 810–819 from the ICD–9–CM (6). Specifically, these codes are: 

E810—Motor vehicle traffic accident involving collision with train

E811—Motor vehicle traffic accident involving re-entrant collision with another motor vehicle

E812—Other motor vehicle traffic accident involving collision with motor vehicle

E813—Motor vehicle traffic accident involving collision with other vehicle

E814—Motor vehicle traffic accident involving collision with pedestrian

E815—Other motor vehicle traffic accident involving collision on the highway

E816—Motor vehicle traffic accident due to loss of control, without collision on the highway

E817—Noncollision motor vehicle traffic accident while boarding or alighting
NCHS Data Brief ■ No. 185 ■ January 2015

■  7  ■

E818—Other noncollision motor vehicle traffic accident

E819—Motor vehicle traffic accident of unspecified nature

Data source and methods

Data are from the 2010–2011 NHAMCS, an annual nationally representative survey of 

nonfederal, general, and short-stay hospitals that is conducted by the Centers for Disease Control 

and Prevention’s (CDC) National Center for Health Statistics. NHAMCS uses a multistage 

probability design with samples of primary sampling units (PSUs), hospitals within PSUs, and 

patient visits within EDs. Each year, approximately 480 hospitals are selected for inclusion in 

NHAMCS. Data were collected on approximately 35,000 ED visits in 2010 and 31,000 visits in 

2011. Additional information on the methodology of NHAMCS is available online (7). 

Data were imputed for patient birth year, race, ethnicity, and triage level (7). For the ED 

component of NHAMCS, race data were missing for 10.5% of visits in 2010 and 12.9% of visits 

in 2011; ethnicity data were missing for 12.8% of visits in 2010 and 16.2% of visits in 2011; 

and triage data were missing for 20.4% of visits in 2010 and 19.6% of visits in 2011. Race and 

ethnicity data were combined in Figure 2 to form the categories of Hispanic, non-Hispanic white, 

and non-Hispanic black; visits by other racial and ethnic groups are not shown in this figure. The 

primary diagnosis groups shown in Figure 5 correspond to the following ICD–9–CM codes: 

720–724—Spinal disorders

800–829—Fractures

840–845 and 848—Sprains and strains excluding neck and back

846–847—Sprains and strains of neck and back

870–897—Open wound

920–924—Contusion with intact skin surface

V71—Observation and evaluation for suspected conditions not found 

Data analyses were performed using the statistical packages SAS, version 9.3 (SAS Institute, 

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

N.C.). Differences among subgroups were evaluated using a two-tailed t test (p < 0.05).

About the authors

Michael Albert and Linda F. McCaig are with CDC’s National Center for Health Statistics, 

Division of Health Care Statistics.
NCHS Data Brief ■ No. 185 ■ January 2015

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References

1. CDC. Ten significant public health achievements—United States, 

2001–2010: Motor vehicle safety. Available from: http://www.cdc.gov/

Motorvehiclesafety/mmwr_achievements.html.

2. CDC. Injury prevention & control: Motor vehicle safety. Available from: 

http://www.cdc.gov/motorvehiclesafety/costs/index.html.

3. CDC. FastStats: Accidents or unintentional injuries. Available from: 

http://www.cdc.gov/nchs/fastats/accidental-injury.htm.

4. Naumann RB, Dellinger AM, Zaloshnja E, Lawrence BA, Miller TR. 

Incidence and total lifetime costs of motor vehicle-related fatal and nonfatal 

injury by road user type, United States, 2005. Traffic Inj Prev 11(4):353–60. 

2010.

5. U.S. Department of Health and Human Services, Office of Disease 

Prevention and Health Promotion. Healthy People 2020 topics and 

objectives: Injury and violence prevention. Washington, DC. Available from: 

http://www.healthypeople.gov/2020/topics-objectives/topic/injury-andviolence-prevention/objectives.

6. Centers for Medicare & Medicaid Services. International classification of 

diseases, ninth revision, clinical modification, 6th ed. DHHS Pub No. (PHS) 

06–1260. 2006. Available from: http://www.cdc.gov/nchs/icd/icd9cm.htm.

7. NCHS. 2010 NHAMCS micro-data file documentation. 2010. Available 

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

NHAMCS/doc2010.pdf.

Suggested citation

Albert M, McCaig LF. Emergency 

department visits for motor vehicle traffic 

injuries: United States, 2010–2011. NCHS 

data brief, no 185. Hyattsville, MD: National 

Center for Health Statistics. 2015.

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Statistics

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Director for Science

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