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Top 20 Most Common ER Diagnoses

April 16, 2019 BY Alanna Moriarty

Top 20 Most Common ER Diagnoses

Hospital emergency departments are on the front lines of patient care, providing vital information and insights into population health trends. Emergency room (ER) use data can aid hospital leaders and providers in understanding the needs of their patients -- particularly for rural communities.

As seen in the table below, patients primarily seek care at emergency departments for non-emergency medical events. Chest pain is by far the most common reason diagnosis at hospital ERs.

 

As a symptom of serious conditions like heart attacks, pleurisy, pneumonia, hypertension, and more, chest pain is not a symptom to be taken lightly. However, chest pain is often unrelated to the heart, and can be a symptom of muscle strain, tissue inflammation, bruised ribs, and other non-life-threatening injuries.

Headaches, which take the number 4 spot, play a similar role in alerting patients to potentially life-threatening medical conditions -- but generally not being cause for much concern. Though headaches can be a symptom of serious illnesses like brain tumors and aneurysms, they are often caused by muscle tension, sleep deprivation, and certain medications. 

 

Top 20 ER Diagnoses at Hospitals

Rank ICD-10 Code ICD-10 Description Est Total Claims
1.  R0789, R079   Other chest pain, chest pain unspecified 4,346,349 
2.  J069   Acute upper respiratory infection, unspecified 2,504,641 
3.  N390   Urinary tract infection, site not specified 1,485,188 
4.  R51   Headache 1,346,546 
5.  R109   Unspecified abdominal pain 1,300,583 
6.  R55   Syncope and collapse 1,084,963 
7.  K529   Noninfective gastroenteritis and colitis, unspecified 1,037,738 
8.  R42   Dizziness and giddiness 973,404 
9.  M545   Low back pain 947,389 
10.  S0990XA   Unspecified injury of head, initial encounter 936,779 
11.  R112   Nausea with vomiting, unspecified 923,386 
12.  J029   Acute pharyngitis, unspecified 918,589 
13.  J45901   Unspecified asthma with (acute) exacerbation 907,744 
14.  K5900   Constipation, unspecified 854,185 
15.  J209   Acute bronchitis, unspecified 831,156 
16.  S161XXA   Strain of muscle, fascia and tendon at neck level, initial encounter 796,144 
17.  R509   Fever, unspecified 745,105 
18.  K0889   Other specified disorders of teeth and supporting structures 716,165  
19.  R1013   Epigastric pain 677,577 
20.  S39012A   Strain of muscle, fascia and tendon of lower back, initial encounter 655,739 

Fig 1 Data from Definitive Healthcare's hospitals and IDNs platform using all-payor claims data from CY 2017.

How ERs Serve Rural Patients

Patients living in rural areas of the U.S. often use care facilities and ERs differently than urban patients. There are likely to be fewer urgent care centers in regions with a low population density, leaving patients to rely on hospital emergency departments for unexpected care. 

Disturbingly, this can include chronic care management. If patients do not have regular access to specialists, they are more likely to bring themselves and their family members to the nearest hospital emergency department for rapid treatment of their symptoms. Rural patients are also more likely to be uninsured, further restricting the care they can access. However, even those with insurance may have difficulty finding covered providers within a reasonable distance of their homes, preventing them from seeking care outside their local ER.

According to a study from the University of New Mexico, rural emergency department visits rose from 16.7 million to 28.4 million between 2005 and 2016 -- a difference of more than 70 percent. In the same time period, urban hospital visits grew by just under 19 percent.

Even in urban areas, emergency departments are often overcrowded, with some patients waiting upwards of two hours. In many cases, these extended wait times are due to patients seeking unnecessary care or treatment for non-life-threatening issues (as seen in the table above) such as chronic pain, psychosis, sprains, fractures, and other ailments better suited to urgent care centers. Avoidable emergency room visits like those listed can lead to the delay of medication administration and other treatments for patients in imminent danger from more serious injuries. Often, patients simply aren't sure what constitutes an emergency department visit rather than a trip to urgent care -- some patients may not even be aware there is a difference between the two care centers.

To reduce wait times and improve care outcomes, some hospital ERs are employing telehealth software. Patients are assessed by an NP or PA upon arrival for stability, and lower-risk patients are eligible to consult with an in-network physician at another location. New York Presbyterian Weill Cornell Medical Center (NYPWC) launched a telehealth service in July 2016. Within one year, emergency department wait times plummeted from an average of 150 minutes to 18 minutes, according to Definitive Healthcare data.

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