Sociodemographic analysis of pediatric emergency department visits: 2019 NHAMCS

Background: Our primary objective was to analyze and describe the population characteristics — including race and ethnicity, age, insurance status, and comorbidities—among all pediatric ED visits included in the National Hospital Ambulatory Medical Survey (NHAMCS). Due to prevalent healthcare disparities, our secondary objective was to evaluate the demographic factors in triage level, ED wait times, and intentional vs unintentional traumas and poisoning.

Method: We conducted a cross-sectional analysis using the 2021 NHAMCS data to determine the prevalence of pediatric ED visits in the United States. Our sample consisted of 337 hospitals in the US, reporting 16,207 ED visits. We used X² tests logistic regression to assess wait times, triage level, and selfinflicted injuries or poisoning.

Results: Our results showed that Indigenous children's wait times were twice that of other racial groups. Additionally, rates of ED visits for trauma, poisoning, or overdose were higher in non-MSA regions. Lastly, children aged 15-17 had the highest percentage of emergent triage level visits—nearly double the percentage for all other age group categories.

Conclusion: In summary, our study represents a pediatric ED population primarily composed of children under 7 years of age, within MSA regions, and consistent with the national ethnoracial census. More than 12% of pediatric ED patients had 1 or more comorbidities, and nearly 3 in 5 visits were covered through Medicaid/CHIP. To improve overall access and decrease non-emergent ED usage, we recommend that healthcare workers implement extended hours, expanded language services, and use of telehealth.