Approximately one in five adults in the U.S. went to an emergency room for care at least once in 2011, according to Nancy Walsh, writer for MedPage Today. The data comes from the Centers for Disease Control (CDC) which reported that “the total number of visits to emergency departments increased 34% between 1995 and 2010—from 97 million to 130 million visits.” During the same period the number of emergency departments in the U.S. declined by 11% to 3, 700.
Emergency Rooms Treat 20% in U.S.

Adults age 75 and up made 27% of the visits to the emergency department and children younger than six made up 24%. Among Medicaid recipients, 38% used the emergency department at least once, as did 16% of those who had private insurance and 21% of those who had no insurance.
Writers of the report speculated that, “Persons with Medicaid may be sicker than the rest of the population and may find it more difficult to locate other sources of care, and these factors may be reflected in higher emergency department use among adults and children with Medicaid coverage.”
For children, 27% of the visits were for colds while 21% were for treatment of injuries. Injuries were the reason for 14% of the adult visits and injuries related to falls rose to 13% in adults 65 and older. Nine percent of adults complained of abdominal pain and 7% reported chest pain.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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