New Report Studies Emergency Departments Serving High Volumes of “Safety-Net” Patients

For Immediate Release: May 21, 2004

Contact: NCHS/CDC Public Affairs, (301) 458-4800


Characteristics of Emergency Departments Serving High Volumes of Safety-net Patients: United States, 2000. Series Report 13, Number 155. 23 pp. (PHS) 2004-1726 [PDF – 3.7 MB]

An analysis of 2000 data shows that approximately one-third of all U.S. hospital emergency departments serve a disproportionately high number of Medicaid and uninsured patients. These hospitals serve as a safety net in communities whose residents are more likely to be low income, uninsured, or Medicaid recipients, and where there are fewer primary care services available.

The findings, published in a new report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, describe the characteristics of “high safety-net” emergency departments. The study examined hospital, community, and patient factors associated with serving safety-net populations as well as the receipt of public funding.

Some 36 percent of the Nation’s emergency departments are considered high safety-net, defined as those where at least 30 percent of the patients are Medicaid eligible; 30 percent are uninsured; or a total of 40 percent of the patients fall into either category. The majority of the high safety-net emergency departments were in this category, with moderate levels of both uninsured and Medicaid recipients.

The study found that:

  • Emergency departments (ED) located in the South are more likely to serve high safety-net patients. Southern hospitals represent two-thirds of high-burden EDs. EDs located in areas with higher rates of poverty and unemployment and a lower per capita income see a disproportionately larger volume of high safety-net patients.
  • High safety-net EDs are more likely to be in areas with fewer primary care physicians than other communities and their patients include more African Americans and children, but fewer seniors.
  • Although the majority of visits at all EDs are for critical conditions, patients at safety-net hospitals are more likely to be treated for nonurgent conditions, such as toothache or back pain. Patients at high safety-net hospitals are less likely to have injuries, less likely to be admitted to the hospital, and more likely to be seen by a resident or intern under the direction of a staff physician.
  • Nationally, only 41 percent of high safety-net EDs are in hospitals that receive any Federal assistance for treating a disproportionate share of Medicaid and uninsured patients.
  • Hospitals located in the South that have a high safety-net burden are the least likely to receive Federal subsidy funds compared with hospitals in other regions of the country.

“Characteristics of emergency departments serving high volumes of safety-net patients: United States, 2000” can be viewed at the NCHS Web site. The Web site also contains additional information about the survey based on records from a representative sample of the nation’s emergency departments.