Monitoring Health Care in America

Quarterly Fact Sheet – September 1995

Spotlight on: Injuries

There were approximately 34 million injury-related visits to hospital emergency departments (ED) in 1992, or 40 percent of all ED visits. Males had a significantly higher rate of injury visits than females, and youths aged 15-24 years had the highest rate of any age group. Over 9.2 billion dollars were spent on injury-related (ED) visits in 1992.

Accidental falls, most common

Accidental falls account for 23 percent of all injury-related ED visits, followed by motor vehicle accidents (12 percent); accidentally being struck by people, objects, or falling objects (11 percent); cuts or punctures by sharp objects (9 percent); and violence (5 percent). In 1993 there were over 145,000 deaths attributed to injury-related causes such as accidents and adverse effects, suicide, and homicide and legal intervention. Accidents were the fifth leading cause of death in 1993, while suicide was the ninth leading cause and homicide was the tenth leading cause.

Doctor Visits

There were 23.8 million office visits to physicians because of injuries in 1992, accounting for 3 percent of all patient visits. Injuries and poisoning were responsible for 7.5 percent of all principal diagnoses for patients in 1992, a total of 57.4 million diagnoses. Sprains and strains of the back alone accounted for more than 7.7 million principal diagnoses in 1992.

Outpatient, inpatient visits

Over 2.4 million visits to hospital outpatient departments in 1992 were due to injuries, accounting for over 4 percent of all outpatient visits. Back symptoms were responsible for 763,000 or 1.3 percent of all visits, while knee symptoms accounted for 535,000 visits or 1 percent of the total. Back disorders were the principal diagnosis for 679,000 outpatient visits.

In 1993 there were over 2.7 million patients discharged from short-stay hospitals due to injuries. Over one million of these patients were discharged for fractures, 160,000 were discharged for intracranial injuries, and 171,000 were discharged for lacerations and open wounds. Patients admitted for injury and poisoning stayed an average of 6.4 days in the hospital (7.5 days for fractures, 7.3 days for intracranial injuries, and 3.7 days for lacerations and open wounds).

Health insurance coverage

Over 17 percent of the under 65 years of age population — or 40 million Americans — had no health insurance coverage in 1993. Nearly 8.4 million children under 15 years of age were uninsured. One out of three Hispanic Americans, one out of four Black Americans, and one out of six White Americans under 65 years of age had no insurance. Among Hispanics, nearly 40 percent of Mexican Americans, 21 percent of Puerto Ricans, and 17 percent of Cubans were uninsured in 1993.

Over 42 million Americans, or 16 percent of the population, were enrolled in health maintenance organizations (HMOs) in 1994, twice as many as in 1985 and 7 times as many as in 1976. Thirty-eight percent of enrollees belonged to individual practice associations, while 32 percent belonged to group associations and another 30 percent belonged to mixed plans.

Meanwhile, between 1991 and 1994, private employers’ health insurance costs per employee-hour worked increased by 24 percent, to $1.14 an hour. In comparison, wages and salaries per employee-hour worked increased by 9 percent during the same period.

Health expenditures

Personal health expenditures in the U.S. totaled over $782 billion in 1993, more than triple the total in 1980. Hospital care expenditures accounted for $327 billion or 42 percent of the total, while physician services cost $171 billion (22 percent) and nursing home care costs totaled 69.9 billion or 9 percent of the total.

For more information or to arrange an interview with the author, please contact NCHS, Office of Public Affairs (301) 458-4800, or via e-mail at

Data Sources

Advance Data From Vital and Health Statistics

No. 248. National Hospital Ambulatory Medical Care Survey: 1992 Outpatient Department Summary

No. 253. National Ambulatory Medical Care Survey: 1992 Summary

No. 261. Injury-Related Visits to Hospital Emergency Departments: United States, 1992. 20 pp. (PHS) 95-1250 [PDF – 228 KB]

No. 264. 1993 Summary: National Hospital Discharge Survey. 12 pp. (PHS) 95-1250 [PDF – 108 KB]

Monthly Vital Statistics Report

Annual Summary of Births, Marriages, Divorces, and Deaths: United States, 1993, Vol. 42, No. 13

Health, United States

Health, United States, 1994. 307 pp. (PHS) 95-1232. GPO stock number 017-022-01295-2 price $20.00 [PDF – 2 MB]