Related Experiment Video
Updated: Apr 15, 2026
Detection of Polyfunctional T Cells in Children Vaccinated with Japanese Encephalitis Vaccine via the Flow Cytometry Technique
Published on: September 23, 2022
Infectious Disease-related Emergency Department Visits Among Children in the US
Kohei Hasegawa1, Yusuke Tsugawa, Ari Cohen
1From the *Department of Emergency Medicine, Massachusetts General Hospital; †Harvard Medical School, Boston, MA; and ‡Harvard Interfaculty Initiative in Health Policy, Cambridge, MA.
Insights
Infectious disease emergency department visits are common in US children, particularly those with Medicaid or from low-income households. These visits represent a significant public health burden and cost billions annually.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Infectious disease (ID) research often overlooks emergency department (ED) utilization, providing an incomplete view of healthcare access.
- This study addresses the burden and epidemiological characteristics of ID-related ED visits in U.S. children.
Purpose of the Study:
- To quantify the incidence and characteristics of infectious disease-related emergency department visits among children in the United States.
- To analyze the associated hospitalizations and healthcare charges.
Main Methods:
- Cross-sectional analysis of the Nationwide Emergency Department Sample (NEDS) data from 2011.
- Identification of pediatric patients with a primary diagnosis of infectious disease.
- Outcome measures included ED visits, hospitalizations, and ED charges.
Main Results:
- Over 8.5 million infectious disease-related ED visits occurred among U.S. children in 2011, constituting 28% of all pediatric ED visits.
- Upper respiratory infections were the most common diagnosis (41%), followed by otitis media (18%) and lower respiratory infections (14%).
- Children with Medicaid (62%) and those in the lowest income quartile (35%) were disproportionately represented. 5% of visits resulted in hospitalization, costing $9.6 billion annually.
Conclusions:
- Infectious diseases impose a substantial public health burden on U.S. children, evidenced by high ED visit rates, hospitalizations, and significant healthcare costs.
- Children from lower socioeconomic backgrounds utilize ED services for infectious diseases at a disproportionately high rate.
Background:
Although most research on infectious diseases (IDs) has focused on hospitalizations, this provides an incomplete picture of healthcare utilization. We describe the burden and epidemiologic features of ID-related emergency department (ED) visits among U.S. children.
Methods:
We conducted a cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We identified children who presented to the ED with a primary diagnosis of ID. Outcome measures were ID-related ED visits, hospitalizations through the ED and ED charges.
Results:
During 2011, we identified 1,914,509 ID-related ED visits among U.S. children, corresponding to a weighted estimate of 8,524,357 ED visits. This accounted for 28% of all ED visits by children. The frequency of ID-related ED visits was 10,290 visits per 100,000 children. The most common diagnoses were upper respiratory infection (41%), otitis media (18%) and lower respiratory infection (14%). Overall, 62% of ID-related ED visits were made by children with Medicaid; 35% were by those in the lowest income quartile. Among the ID-related ED visits, 424,725 (5%) resulted in hospitalization, with 513 hospitalizations per 100,000 children. The most common reason for hospitalization was lower respiratory infection, which accounted for 40% of all ID-related hospitalizations from the ED. Median charge per ED visit was $718, with total annual charges of $9.6 billion.
Conclusions:
The public health burden of IDs, as measured by ED visits, subsequent hospitalizations and associated charges, was substantial. We also found that children with markers of lower socioeconomic status comprised a disproportionately high proportion of ID-related ED visits.
Related Concept Videos
01:28Infectious Diseases and Their Occurrence
01:23Investigation of Disease Outbreaks
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:18Steps in Outbreak Investigation
01:18Bacterial Gastroenteritis
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion